Complications

Complication
Timeframe
Likelihood
short term
low

Caused by hypoventilation due to respiratory muscle weakness and aspiration due to decreased level of consciousness. Increased risk in immunocompromised people. Should be treated with appropriate antibiotics.[46]​​

short term
low

Occurs in neuroinvasive disease secondary to respiratory muscle weakness. Requires mechanical ventilation and, if persistent, may require tracheostomy.[46][52]​​​

short term
low

Occurs in neuroinvasive disease. Treatment is usually supportive care, with respiratory support and anticonvulsants if seizures develop. Safety and efficacy of intravenous corticosteroids has not been established.[85][86]

short term
low

Flaccid paralysis predisposes patients to deep vein thrombosis. Can be prevented or treated with appropriate anticoagulation.[46]​​

short term
low

Infection stresses the immune system and body, rendering the patient more susceptible to infections from bacteria that are usually present (e.g., Staphylococcus, Streptococcus) and may not cause an active infection in a healthy individual. Therefore, the patient must be watched vigilantly for any signs of a bacterial infection. For example, if a patient develops any respiratory symptoms, such as a cough, the physician should have a lower threshold for ordering a chest x-ray to evaluate for pneumonia. Treat with antibiotics specific to infection.

variable
high

Occurs in West Nile fever or neuroinvasive disease, and persists for months. More likely to persist in neuroinvasive disease (especially West Nile encephalitis). Treatment is supportive.[84]

variable
high

Occurs in West Nile fever or neuroinvasive disease and persists for months. Can be treated with analgesia.[84]

variable
medium

Can occur in patients with West Nile encephalitis, although one study found that cognitive deficits can manifest regardless of infection severity.[89] Can be permanent and cognitive retraining may be necessary.[40]

variable
low

Occurs in West Nile poliomyelitis (WNP) following flaccid paralysis and may persist for months. Can be treated with physiotherapy.[84][87]

variable
low

Occurs in neuroinvasive disease and may persist for months. Can be treated with physiotherapy.[87] Rare cases of opsoclonus myoclonus ataxia have been reported.[88]

variable
low

Hepatitis should be suspected if the patient has jaundice, right upper quadrant abdominal pain, and tenderness. Frequently self-limiting, but could progress to fulminant hepatitis. This complication is very rare, and treatment is supportive.

variable
low

Typically presents with severe abdominal pain and elevated serum amylase/lipase. This complication is very rare, and treatment is supportive.

variable
low

Suspected when cardiac echocardiogram or electrocardiography is abnormal, and cardiac enzymes (troponin and creatine phosphokinase) are raised. Could result in life-threatening arrhythmias. This complication is very rare, and treatment is supportive.

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