Abstract：
Background: Eastern equine encephalitis virus (EEEV) is a rare mosquito-borne illness exhibiting rapid neurological deterioration and permanent damage. Despite its >30% mortality and >60% long-term neurological damage, EEEV has no approved antiviral medication or vaccination. This report uniquely aims to describe a rare case of EEEV and provide a current literature review of therapeutic and preventative options from the clinical perspective to guide clinicians and public health workers, along with informing them about its impact and current knowledge gaps. Methods: A retrospective chart review of the electronic medical record was performed for a patient\'s 10-day hospital admission in July 2021. In addition, PubMed was searched using relevant keywords for a literature review of EEEV. Results: A 61-year-old woman presented with dysarthria and right-sided facial droop. Acute ischemic stroke was ruled out, and empiric intravenous (IV) antibiotics were initiated for possible infectious etiology. The patient developed worsening mental status and fever and was intubated, with antibiotics broadened with concern for meningitis along with tick-borne illness. The patient remained encephalopathic and febrile, and lumbar serologies were consistent with viral meningoencephalitis or acute disseminated encephalomyelitis. Several days after collection, quantitative antibody testing returned positive for EEEV. The patient was pronounced dead on hospital day 10. On review of the literature regarding EEEV, supportive care and prevention remain the cornerstone of management. Although early IV immunoglobulin and high-dose steroids have shown potential as treatments to reduce morbidity and mortality, no vaccines have been approved to date. Conclusion: Prospective trials and further investigations into treatment and preventative options may be useful in reducing the morbidity and mortality associated with EEEV.
摘要：
背景：东方马脑炎病毒（EEEV）是一种罕见的蚊媒疾病，表现出迅速的神经系统恶化和永久性损害。尽管其死亡率>30%，长期神经损伤>60%，EEEV没有批准的抗病毒药物或疫苗接种。本报告旨在描述罕见的EEEV病例，并从临床角度提供治疗和预防选择的最新文献综述，以指导临床医生和公共卫生工作者。同时告知他们其影响和当前的知识差距。方法：对2021年7月患者住院10天的电子病历进行回顾性分析。此外,使用相关关键词搜索PubMed以获取EEEV的文献综述。结果：一名61岁女性出现构音障碍和右侧面部下垂。排除了急性缺血性卒中,并开始经验性静脉（IV）抗生素治疗可能的感染病因。病人出现精神状态恶化及发热,并进行插管,随着对脑膜炎和蜱传播疾病的关注，抗生素扩大了。病人仍然是脑病和发热，腰椎血清学与病毒性脑膜脑炎或急性播散性脑脊髓炎一致。收集几天后，EEEV的定量抗体检测结果为阳性。患者在医院第10天被宣布死亡。在回顾有关EEEV的文献时，支持性护理和预防仍然是管理的基石。尽管早期静脉免疫球蛋白和高剂量类固醇已显示出作为降低发病率和死亡率的治疗方法的潜力，迄今为止，尚未批准任何疫苗。结论：前瞻性试验以及对治疗和预防选择的进一步研究可能有助于降低与EEEV相关的发病率和死亡率。
