West Nile virus (WNV), a single-stranded RNA flavivirus, has spread across the United States since arriving in 1999. While asymptomatic or self-limited in a majority of patients, WNV can cause a severe neuroinvasive disease, which occurs more often in transplant recipients with chronic immunosuppression. Diagnosis of acute WNV infection usually relies on serologic identification of immunoglobulin M (IgM) specific for the virus. We report a fatal case of naturally acquired WNV encephalitis in a renal and pancreas transplant recipient who was seronegative for WNV-specific IgM but had detectable WNV RNA by nucleic acid amplification testing (NAAT) several weeks after the onset of symptoms. This case demonstrates the importance of using both serologic assays and NAAT for WNV in transplant recipients with the clinical suspicion of encephalitis.

Original languageEnglish (US)
Pages (from-to)459-464
Number of pages6
JournalTransplant Infectious Disease
Issue number5
StatePublished - Oct 2010


  • Diagnosis
  • Immunosuppression
  • Nucleic acid amplification testing
  • Renal and pancreas transplant
  • Serology
  • Transplant
  • West Nile virus

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation


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