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Abstract Details

Atypical Eastern Equine Encephalitis in an Immunocompromised Patient: Diagnostic Challenges With Unique MRI Findings
Infectious Disease
P5 - Poster Session 5 (11:45 AM-12:45 PM)
3-001
To highlight the diagnostic complexity of Eastern equine encephalitis (EEE) in immunocompromised patients and examine how atypical imaging and CSF findings can delay identification.
EEE is a rare but often fatal arboviral infection. Immunocompromised individuals may present atypically, complicating diagnosis and delaying treatment.
NA
A 64-year-old man with multiple myeloma presented with fever, seizures, and coma. CSF showed a shift from neutrophilic to lymphocytic pleocytosis. Standard viral and autoimmune panels were negative. MRI brain revealed cortical and subcortical diffusion restriction rather than classic deep gray matter involvement of arboviral infection. EEE virus RNA was eventually detected by a state-specific PCR panel. Despite treatment, the patient deteriorated neurologically and transitioned to comfort care. Postmortem confirmed encephalitis. This case marks the first reported instance of EEE in New York State in the past decade.
EEE can present with non-classical imaging and diagnostic findings in immunosuppressed hosts. Broader diagnostic approaches and earlier empiric treatment may improve outcomes.
Authors/Disclosures
Zhimin Xu, MD, PhD (Westchester Medical Center)
PRESENTER 		Dr. Xu has nothing to disclose.
Subhan Khan, MD (University of Kentucky) Dr. Khan has received personal compensation for serving as an employee of University of Kentucky.
Ahya S. Ali, MD (Westchester Medical Center) Dr. Ali has nothing to disclose.
Terry Park, MD (Westchester Medical Center) Dr. Park has nothing to disclose.
Fang Yu, MD Fang Yu has nothing to disclose.
Jon Rosenberg, MD Dr. Rosenberg has nothing to disclose.
Fawaz Al-Mufti, MD (Westchester Medical Center at New York Medical College) Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Stryker. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Revalesio .