{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:54:17Z","timestamp":1787504057652,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Literature on the natural course of neuroinvasive West Nile virus (WNV) infection in solid organ transplant (SOT) recipients is sparse. In the setting of a 2021 WNV outbreak in Arizona, we reviewed our institution's experience with neuroinvasive WNV infection in patients with SOT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively identified SOT recipients treated for neuroinvasive WNV at Mayo Clinic in Arizona from 2007 through 2021. Clinical manifestations, disease course, and outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 24 SOT recipients with WNV infection identified during the study period, 13 infections occurred in 2021. Most patients had gastrointestinal tract symptoms and fever at disease presentation. Five patients had cognitive impairment, and 14 initially or eventually had acute flaccid paralysis. Clinically significant deterioration occurred at a median of 4 (range, 1\u201311) days after hospital admission. Seventeen patients (71%) were transferred to the intensive care unit, with 15 requiring mechanical ventilation. Initial cerebrospinal fluid analysis mainly demonstrated a neutrophil\u2010predominant pleocytosis. Almost all patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a023) were treated with intravenous immunoglobulin alone or in combination with interferon alfa\u20102b. Sixteen patients had clinical improvement, 4 of whom recovered completely. Six patients died during hospitalization due to complications of neuroinvasive WNV infection. Two patients were discharged to hospice without clinical recovery. The overall 30\u2010day mortality rate was 36%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Despite advances in supportive care, neuroinvasive WNV infection is associated with substantial morbidity and mortality in SOT recipients. Flaccid paralysis is an indicator of poor prognosis.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14004-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.14004","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T07:14:03Z","timestamp":1672125243000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Neuroinvasive West Nile virus infection in solid organ transplant recipients"],"prefix":"10.1111","volume":"25","author":[{"given":"Sabirah N.","family":"Kasule","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Mayo Clinic Hospital  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2006-1236","authenticated-orcid":false,"given":"Simran","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mayo Clinic Hospital  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7187-478X","authenticated-orcid":false,"given":"Roberto L.","family":"Patron","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Mayo Clinic Hospital  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie F.","family":"Grill","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Hospital  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6391-0349","authenticated-orcid":false,"given":"Holenarasipur R.","family":"Vikram","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Mayo Clinic Hospital  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Centers for Disease Control and Prevention. West Nile virus. [Internet].2020. Accessed Jun 8 2020.https:\/\/www.cdc.gov\/westnile\/index.html"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/376230"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00045-12"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1940.s1-20.471"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200106143442401"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-248"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-013-0367-8"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2004.00592.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000024"},{"key":"e_1_2_9_11_1","unstructured":"Arizona Department of Health Services\u2010Office of Infectious Disease Services.Arizona 2021 West Nile Virus Statistics.2021. Accessed March 20 2022.https:\/\/www.azdhs.gov\/documents\/preparedness\/epidemiology\u2010disease\u2010control\/mosquito\u2010borne\/west\u2010nile\/data\/west\u2010nile\u2010virus\u2010stats\u20102021.pdf?v=20211006"},{"key":"e_1_2_9_12_1","unstructured":"Arizona Department of Health Services\u2010Office of Infectious Disease Services.Arizona 2004 WNV Statistics.2004. Accessed March 1 2022.https:\/\/www.azdhs.gov\/documents\/preparedness\/epidemiology\u2010disease\u2010control\/mosquito\u2010borne\/west\u2010nile\/data\/2004wnv.pdf"},{"key":"e_1_2_9_13_1","unstructured":"Arizona Department of Health Services\u2010Office of Infectious Disease Services.Arizona West Nile Virus (WNV) Epi Profile.2018. Accessed March 1 2022.https:\/\/www.azdhs.gov\/documents\/preparedness\/epidemiology\u2010disease\u2010control\/mosquito\u2010borne\/vector\u2010graphs\u2010wnv.pdf"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.8042"},{"key":"e_1_2_9_15_1","article-title":"This year's monsoon has been one of Arizona's wettest","author":"Lis E","year":"2021","journal-title":"Cronkite News"},{"key":"e_1_2_9_16_1","article-title":"Average highs in November hottest on record in Phoenix: NWS","author":"Sievers C","year":"2021","journal-title":"Patch"},{"key":"e_1_2_9_17_1","unstructured":"Arizona Department of Health Services\u2010Office of Infectious Disease Services.2021 Arbo` Activity in the Pacific Southwest.2021.https:\/\/www.azdhs.gov\/documents\/preparedness\/epidemiology\u2010disease\u2010control\/mosquito\u2010borne\/arbo\u2010az\u20102021.pdf?v=20211221"},{"key":"e_1_2_9_18_1","unstructured":"Maricopa County Environmental Services Department.Mosquito\u2010Borne Disease Surveillance.2022. Accessed March 21 2022.https:\/\/www.maricopa.gov\/2476\/Mosquito\u2010Borne\u2010Disease\u2010Statistics"},{"key":"e_1_2_9_19_1","unstructured":">Arizona Department of Health Services\u2010Office of Infectious Disease Services.Arizona 2019 West Nile Virus Statistics.2019. Accessed Jun 8 2020.https:\/\/www.azdhs.gov\/documents\/preparedness\/epidemiology\u2010disease\u2010control\/mosquito\u2010borne\/west\u2010nile\/data\/west\u2010nile\u2010virus\u2010az\u20102019.pdf"},{"key":"e_1_2_9_20_1","unstructured":"Arizona Department of Health Services\u2010Office of Infectious Disease Services. Arizona 2018 West Nile Virus Statistics.2019. Accessed Jun 8 2020.https:\/\/www.azdhs.gov\/documents\/preparedness\/epidemiology\u2010disease\u2010control\/mosquito\u2010borne\/west\u2010nile\/data\/west\u2010nile\u2010virus\u2010az\u20102018.pdf"},{"key":"e_1_2_9_21_1","unstructured":"Mayo Clinic.Kidney Transplant Program: Volumes and Outcomes. Accessed May 11 2021.https:\/\/www.mayoclinic.org\/departments\u2010centers\/kidney\u2010transplant\/sections\/outcomes\/txc\u201020203218"},{"key":"e_1_2_9_22_1","unstructured":"Mayo Clinic.Heart Transplant Program: Volumes and Outcomes. Accessed May 11 2021.https:\/\/www.mayoclinic.org\/departments\u2010centers\/heart\u2010transplant\/sections\/outcomes\/ooc\u201020212189"},{"key":"e_1_2_9_23_1","unstructured":"Mayo Clinic.Liver Transplant Program: Volumes and Outcomes. Accessed May 11 2021.https:\/\/www.mayoclinic.org\/departments\u2010centers\/liver\u2010transplant\/sections\/outcomes\/ooc\u201020212031"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022987"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.8.1210"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.2.727-733.2004"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/v5102329"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12764"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489419866219"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2003.09.007"},{"issue":"7","key":"e_1_2_9_31_1","article-title":"West Nile virus encephalitis with acute parkinsonism features: a case report and review of literature (P01.050)","volume":"80","author":"Javalkar V","year":"2013","journal-title":"Neurology"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1086\/383325"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1099\/vir.0.000079"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20080421"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-9-18"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0801.010252"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.79.21.13350-13361.2005"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.4_MeetingAbstracts.343S"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.03.042"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2511.190537"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.592017"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14004","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.14004","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T16:57:24Z","timestamp":1692291444000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.14004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,10]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1111\/tid.14004"],"URL":"https:\/\/doi.org\/10.1111\/tid.14004","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,10]]},"assertion":[{"value":"2022-08-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14004"}}