Vitritis and chorioretinitis in a patient with West Nile virus infection

Objective: To describe the visual outcome, fundus appearance, and fluorescein angiographic findings of a patient diagnosed as having acute West Nile virus infection. Methods: We conducted comprehensive eye examinations, including visual acuity testing and slitlamp and fundus examinations, along with fluorescein angiography at the initial and follow-up visits. Results: A 62-year-old white woman had a 2-week history of floaters in her left eye along with symptoms of fatigue, a left-sided frontal headache, and a low-grade fever. She was found to have anterior uveitis, vitritis, and nonnecrotizing chorioretinitis in her left eye with similar but milder findings in the right eye. The anterior uveitis responded to topical steroids. Because of continued fevers and fatigue, a serologic test for West Nile virus immunoglobulin M was performed, and the results were found to be positive for this disease. Conclusion: These unique eye findings, along with associated systemic signs and symptoms, can potentially indicate infection with the West Nile virus.