Is West Nile virus a likely cause of the low‑grade fever, myalgias, fatigue, brief nausea, loss of appetite, and transient trunk rash in a previously healthy adolescent boy?

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Last updated: September 28, 2026 • View editorial policy

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Одговор

Највероватније НЕ — описани симптоми код здравог адолесцента више одговарају бенигном, самоограничавајућем вирусном обољењу него инфекцији западним Нилом, осим ако постоји јасан сезонски и епидемиолошки ризик (изложеност комарцима у лето/јесен у ендемском подручју) И/ИЛИ неуролошки знаци. 1, 2, 3

Како одлучити (приоритет: морбидитет, морталитет, квалитет живота)

  • Ако НИЈЕ лето/рана јесен И нема значајне изложености комарцима у ендемском крају → WNV је мало вероватан; симптоми су најчешће неспецифична вирусоза; симптоматска нега. 3, 2
  • Ако ЈЕ лето/рана јесен И постоји уједи комараца/боравак напољу у ендемском подручју:
    • Без неуролошких симптома (главобоља се може јавити, али без менингеалних знакова, конфузије, слабости, парезе): и даље ниска вероватноћа WNV; већина WNV је асимптоматска или блага грозница; лабораторије нису рутинске. 2, 3
    • Са неуролошким знацима (сметње свести, менингизам, фокални дефицит, пареза, атаксија) → одмах тестирај на WNV због ризика од неуроинвазивне болести и последица по морбидитет/морталитет. 1, 2

Шта и како тестирати ако сумњаш на WNV (према највишем квалитету/скорijим смерницама)

  • Прва линија: серологија IgM на WNV у серуму (и/или ЦСФ ако је лумбална пункција индикована због неуролошких симптома). Потврда неутрализационим тестом ако пост

References

2
Research

West Nile Virus: A Review.

JAMA, 2025

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