The neurological spectrum of West Nile virus (WNV) varies from aseptic meningitis to encephalitis ± flaccid paralysis. In endemic areas in summer, WNE should be suspected in patients presenting with mental confusion ± flaccid paralysis. WNV may also present with rash and less commonly, diarrhea. Like other viral illnesses, WNV may be accompanied by fever, chills, headache, and myalgias. Except ...