Diplopia: A focal neurologic presentation of West Nile meningoencephalitis

This is a report of a 45-year-old white man who presented to our emergency department with a 2-day history of “seeing double” preceded by a resolving 5-day syndrome of fevers and headache. Clinical suspicion of West Nile virus central nervous system infection was confirmed on the basis of laboratory studies. The current knowledge of West Nile virus pathophysiology and clinical features are discussed. Although commonly associated with global and nonspecific syndromes, this patient presented with focal neurologic symptoms.