Eastern equine encephalitis and use of IV immunoglobulin therapy and high-dose steroids
Douglas R. Wilcox, Sarah Isabel Collens, Isaac H. Solomon, Farrah J. Mateen, Shibani S. Mukerji
Abstract
OBJECTIVE: To determine the clinical presentation and patient outcomes after treatment with IV immunoglobulin (IVIG), high-dose steroids, or standard of care alone in Eastern equine encephalitis (EEE), a mosquito-borne viral infection with significant neurologic morbidity and mortality. METHODS: A retrospective observational study of patients admitted to 2 tertiary academic medical centers in Boston, Massachusetts, with EEE from 2005 to 2019. RESULTS: = 0.02); steroid use was not associated with the mRS score. The mortality was 12%. CONCLUSIONS: Clinicians should suspect EEE in immunocompetent patients with early subcortical neuroimaging abnormalities and CSF neutrophilic predominance. This study suggests a lower mortality than previously reported, but a high morbidity rate in EEE. IVIG as an adjunctive to standard of care may be considered early during hospitalization.