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32 year old white male. He has been sick for about 1 month and was recently diagnosed with West Nile virus. He has had a few fevers. He has had vomiting and when he is around food he gets sick. He's been sleeping all day and also had a chronic headache. He is getting percocet and naproxyn for the pain and headaches and zofran for the nausea. He had a positive blood test. His vision is blurred in the right eye. This started about 3 weeks ago. Since it started it is not getting any better. The patient was hospitalized last week and was on prednisone and imitrex for a few days for migraine. Then the prednisone started to intefere with his sleep so it was stopped after talking with the doctor. Type I diabetic diagnosed in 2009. The sugars have been good. •VA OD: sc20/50 PH20/40 NscJ1 •VA OS: sc20/63 PH20/32 NscJ1 The images show multifocal deep choroidal lesions (RPE) typical of west nile virus. There is also diabetic retinopathy. The retinopathy could be from W Nile virus but probably is not. His vision improved within about a month.

wnv_DM_rydo_081715_01.png
West Nile Virus Multifocal Choroiditis and diabetic retinopathy54 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_02.png
West Nile Virus Multifocal Choroiditis and diabetic retinopathy28 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_03.png
West Nile Virus Multifocal Choroiditis and diabetic retinopathy98 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_04.png
West Nile Virus Multifocal Choroiditis and diabetic retinopathy34 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_05.png
West Nile Virus Multifocal Choroiditis and diabetic retinopathy36 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_06.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy30 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_07.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy41 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_08.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy23 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_09.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy15 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_10.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy40 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_11.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy13 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_12.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy17 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_13.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy14 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_14.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy19 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_15.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy29 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_16.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy16 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_17.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy12 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_18.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy40 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_19.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy14 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_20.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy16 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_21.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy14 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_22.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy19 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_23.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy12 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_24.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy11 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_26.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy15 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_27.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy13 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_28.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy12 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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wnv_DM_rydo_081715_30.jpg
West Nile Virus Multifocal Choroiditis and diabetic retinopathy23 viewsMultifocal and clustered focal lesions are from west nile virus. The retinopathy is probably diabetic but could also be related to west nile virus00000
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32 year old white male. He has been sick for about 1 month and was recently diagnosed with West Nile virus. He has had a few fevers. He has had vomiting and when he is around food he gets sick. He's been sleeping all day and also had a chronic headache. He is getting percocet and naproxyn for the pain and headaches and zofran for the nausea. He had a positive blood test. His vision is blurred in the right eye. This started about 3 weeks ago. Since it started it is not getting any better. The patient was hospitalized last week and was on prednisone and imitrex for a few days for migraine. Then the prednisone started to intefere with his sleep so it was stopped after talking with the doctor. Type I diabetic diagnosed in 2009. The sugars have been good. •VA OD: sc20/50 PH20/40 NscJ1 •VA OS: sc20/63 PH20/32 NscJ1 The images show multifocal deep choroidal lesions (RPE) typical of west nile virus. There is also diabetic retinopathy. The retinopathy could be from W Nile virus but probably is not. His vision improved within about a month.