Clinical Quandaries Posed by Concurrent Human Immunodeficiency Virus (HIV) and West Nile Virus (WNV) infections: Case Report.

Cases of West Nile Virus (WNV), co-existent with Human Immuno deficiency Virus (HIV), are rare with less than eleven cases in the literature. This clinical combination has an overall mortality of about 30%, as WNV has greater risk in patients with an immunocompromised status. Distinguishing between an acute retroviral HIV episode and a WNV infection can be a clinical dilemma. They present with similar symptoms including headaches, joint pains and fever, and a high index of suspicion and clinical acumen is required to isolate both conditions in a clinical presentation. We present a case of a 25 year old female, with dual diagnosis of new onset HIV and WNV, who required prompt diagnosis and medical intervention following presentation in ER for three weeks history of abdominal pain, headaches, joint aches, nausea, subjective fever and non-bilious, and non bloody vomiting.