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West Nile fever - Treatment and prevention
Last reviewed: 06.07.2025
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Treatment of West Nile fever is syndromic, since the effectiveness of antiviral drugs has not been proven. To combat cerebral hypertension, furosemide is used in adults at a dose of 20-60 mg per day, maintaining normal circulating blood volume. With increasing symptoms of edema-swelling of the brain, mannitol is prescribed at a dose of 0.5 g / kg of body weight in a 10% solution, administered quickly for 10 minutes, followed by the introduction of 20-40 mg of furosemide intravenously. In severe cases (coma, respiratory failure, generalized seizures), dexamethasone (dexazone) is additionally prescribed at a dose of 0.25-0.5 mg / kg per day for 2-4 days. Detoxification and compensation for fluid loss are carried out by intravenous infusions of polyionic solutions (solution "trisol"). polarizing mixture and colloidal solutions (10% albumin solution, cryoplasm, rheopolyglucin, rheogluman) in a ratio of 2:1. The optimal daily volume of administered fluid, including oral and tube administration, is 3-4 l for adults and 100 ml/kg of body weight for children.
To combat hypoxia, oxygen inhalations through nasal catheters are used. Patients are transferred to artificial ventilation according to the following indications: excessive dyspnea (RR is two times or more higher than normal), persistent hypoxemia (PaO2, less than 70 mm Hg), hypocapnia (PaCO2, less than 25 mm Hg) or hypercapnia (PaCO2 more than 45 mm Hg), coma, generalized seizures. Electrolyte disturbances and blood osmolarity are corrected.
According to individual indications, treatment of West Nile fever requires the prescription of anticonvulsants, sedatives, antioxidants, drugs that improve cerebral blood flow (pentoxifylline), and, in the presence of secondary bacterial complications, antibiotics.
Patients need balanced enteral-parenteral nutrition, including a complex of vitamins and microelements, and comprehensive care (prevention of hypostatic pneumonia, bedsores, control of stool and diuresis).
Patients are discharged after stable normalization of temperature, regression of neurological disorders and sanitation of the cerebrospinal fluid. The minimum duration of inpatient treatment for patients with neurotoxicosis is 10 days, meningitis - 20 days, meningoencephalitis - 30 days. After discharge from the hospital, patients with neurological disorders require dispensary observation by a neurologist until full recovery of working capacity and regression of neurological symptoms.
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