{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T03:39:02Z","timestamp":1784950742970,"version":"3.55.0"},"reference-count":7,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2018,1,10]],"date-time":"2018-01-10T00:00:00Z","timestamp":1515542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>West Nile virus infection in humans is mostly asymptomatic. Less than 1% of neuro-invasive cases show a fatality rate of around 10%. Acute flaccid paralysis of respiratory muscles leading to respiratory failure is the most common cause of death. Although the peripheral nervous system can be involved, isolated phrenic nerve palsy leading to respiratory failure is rare and described in only two cases in the English literature. We present another case of neurological respiratory failure due to West Nile virus-induced phrenic nerve palsy. Our case reiterates the rare, but lethal, consequences of West Nile virus infection, and the increase of its awareness among physicians.<\/jats:p>","DOI":"10.3390\/diseases6010007","type":"journal-article","created":{"date-parts":[[2018,1,10]],"date-time":"2018-01-10T12:41:10Z","timestamp":1515588070000},"page":"7","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Neurological Respiratory Failure"],"prefix":"10.3390","volume":"6","author":[{"given":"Mohan","family":"Rudrappa","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care, Louisiana State University Health Science Center, Shreveport, LA 71115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4475-1805","authenticated-orcid":false,"given":"Laxmi","family":"Kokatnur","sequence":"additional","affiliation":[{"name":"Department of Neurology, Louisiana State University Health Science Center, Shreveport, LA 71115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleg","family":"Chernyshev","sequence":"additional","affiliation":[{"name":"Department of Neurology, Louisiana State University Health Science Center, Shreveport, LA 71115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1177\/0885066615589734","article-title":"West nile meningoencephalitis presenting as isolated bulbar palsy with hypercapnic respiratory failure","volume":"31","author":"Tso","year":"2016","journal-title":"J. Intens. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1136\/thorax.2003.009092","article-title":"Bilateral diaphragmatic paralysis and related respiratory complications in a patient with West Nile virus infection","volume":"59","author":"Betensley","year":"2004","journal-title":"Thorax"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/376230","article-title":"The global ecology and epidemiology of west nile virus","volume":"2015","author":"Chancey","year":"2015","journal-title":"BioMed Res. Int."},{"key":"ref_4","unstructured":"Centers for Disease Control and Prevention (2017, November 08). West Nile Virus Disease Cases Reported to CDC by State, 1999\u20132016, Available online: https:\/\/www.cdc.gov\/westnile\/statsmaps\/index.html."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"606","DOI":"10.3390\/v6020606","article-title":"Clinical manifestations and outcomes of west nile virus infection","volume":"6","author":"Sejvar","year":"2014","journal-title":"Viruses"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Hart, J., Tillman, G., Kraut, M.A., Chiang, H.-S., Strain, J.F., Li, Y., Agrawal, A.G., Jester, P., Gnann, J.W., and Whitley, R.J. (2014). West nile virus neuroinvasive disease: Neurological manifestations and prospective longitudinal outcomes. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-248"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Morrey, J.D., Siddharthan, V., Wang, H., and Hall, J.O. (2012). Respiratory insufficiency correlated strongly with mortality of rodents infected with west nile virus. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0038672"}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/6\/1\/7\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T14:50:42Z","timestamp":1760194242000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/6\/1\/7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,10]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,3]]}},"alternative-id":["diseases6010007"],"URL":"https:\/\/doi.org\/10.3390\/diseases6010007","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,10]]}}}