Systemic distribution of West Nile virus infection: Postmortem immunohistochemical study of six cases

Henry B. Armah, Guoji Wang, Bennet I. Omalu, Robert B. Tesh, Kymberly A. Gyure, Dennis J. Chute, Roger D. Smith, Paul Dulai, Harry V. Vinters, Bette K. Kleinschmidt-Demasters, Clayton A. Wiley

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Rare cases of West Nile virus (WNV)-associated inflammation outside the central nervous system (CNS) have been reported. We evaluated the systemic distribution of WNV in postmortem tissues during encephalitis in six patients using immunohistochemistry. WNV antigens were detected in neurons of CNS (all 6 cases), kidney (4 cases), lungs (2 cases), pancreas (2 cases), thyroid (2 cases), intestine (2 cases), stomach (1 case), esophagus (1 case), bile duct (1 case), skin (1 case), prostate (1 case) and testis (1 case). In systemic organs epithelial cells were infected. In none of the six cases were viral antigens identified in hepatocytes, heart, adrenal gland, nerves, skeletal muscles, bone, vessels and fat. All cases in which viral antigens were identified in systemic organs in addition to CNS were severely immunocompromised transplant recipients. With the exception of testis and brain, most foci of infection were not associated with inflammation. While the absence of inflammation may in part be due to patient immunosuppression or to possible transient nature of any host response, compartmentalization of viral antigen to the luminal region of epithelial cells may sequester WNV from immune recognition. Comparison of our findings with previous reports suggests that patients with WNV encephalitis can have widespread systemic infection.

Original languageEnglish (US)
Pages (from-to)354-362
Number of pages9
JournalBrain Pathology
Issue number4
StatePublished - Oct 2007
Externally publishedYes

ASJC Scopus subject areas

  • General Neuroscience
  • Pathology and Forensic Medicine
  • Clinical Neurology


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