Brain Teaser

Adapted from the Pan American Society for Clinical Virology’s “Virology Case of the Month,” November 2017.

A 57-year-old woman from Minnesota was admitted to the hospital after having a fever of 102 degrees for four days. Her family said she hadn’t been feeling well for a week. In addition to the fever, she presented with fatigue, confusion, and difficulty walking and speaking. She also had a rash on her abdomen and bilaterally on her thighs. The patient’s head CT scan was normal, and her cerebrospinal fluid was clear with normal glucose but elevated protein levels. The next day, a head MRI showed brain swelling, and her condition continued to worsen. She was intubated and had a continuous EEG monitor placed, which revealed two “focal motor” or partial seizures.

The patient’s family shared she was frequently outdoors, collecting and chopping wood for a wood-burning furnace. Testing confirmed she had contracted Powassan virus. The woman never recovered, dying from her illness three months later.

Question: The vector for Powassan virus can also transmit which of the following infectious agents?

A. Borrelia burgdorferi
B. Chikungunya virus
C. Dengue virus
D. Jamestown Canyon virus
E. Rickettsia rickettsia

(Answer is at the bottom of the page.)

Although things did not end well for the patient described here, there is good news for patients with suspected tick-borne illnesses. Coppe Laboratories is the ONLY commercial reference lab offering Powassan virus testing. When compared to testing provided by state-run labs and the CDC, Coppe’s turnaround time is significantly quicker (results within 10 business days), giving physicians access to the testing they need to make timely treatment decisions. The sooner a patient has a diagnosis, the better the treatment outcome.

The answer to the question written above is A – Powassan virus is transmitted by Ixodes species ticks, similar to Borrelia burgdorferi, the causative agent of Lyme disease.

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