Background: West Nile virus (WNV), although underdiagnosed, is the most common mosquito-borne disease and the second most common cause of viral encephalitis in the United States. Fewer than 1% of those infected develop neuroinvasive disease.
Methods: We present a cluster of 3 cases of neuroinvasive WNV that occurred between August and September 2023 and a review of the literature for neurologic involvement with this virus.
The emergence of metallo-β-lactamase (MBL)-producing Enterobacterales presents unique clinical treatment challenges. Recently developed β-lactam/ β-lactamase inhibitor combination agents, while effective against other carbapenemase-producing organisms, are notably ineffective against MBL producers. While MBLs do not hydrolyze monobactams (aztreonam), many MBL-producing organisms are resistant to aztreonam through alternate mechanisms, leaving cefiderocol as the sole monotherapy treatment option recommended for MBL producers.
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