Profound and Prolonged Lymphocytopenia with West Nile Encephalitis

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Abstract
An outbreak of West Nile encephalitis (WNE) occurred in the New York area during the summer of 1999 [1]. At our institution, 4 serologically proven cases of WNE were detected by use of enzyme immunoassay and plaque reduction neutralization test (titer range, 1 : 80–1 : 2560). All patients had encephalitis, and 1 patient had seizures. All had fever (temperature, ⩽39°C [102°F]), and 1 had relative bradycardia. Three of the 4 patients were women (age range, 56–83 years). Of the 2 patients who had muscle weakness, 1 had flaccid paralysis. Only 1 patient had cervical adenopathy, and none had a skin rash or conjunctivitis. Nausea and vomiting were present in 2 patients, and nonexudative pharyngitis was present in 1 patient.

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