CASES OF NOTEEncephalopathic Presentation of West Nile Virus Neuroinvasive Disease Confounded by Concomitant History of Acute Alcohol WithdrawalProfita, Alyssa DNP, RN, ACNP-BC; Haglund, Kristin PhD, RN, FNP-BCSection Editor(s): Jordan, Kathleen S. DNP, RN, FNP-BC, ENP-C, SANE-P, FAEN, FAANP; Column Editor Author Information Medical College of Wisconsin, Milwaukee (Dr Profita); College of Nursing, Marquette University, Milwaukee, Wisconsin (Dr Haglund); and Froedtert & Medical College of Wisconsin, Milwaukee (Dr Haglund). Corresponding Author: Kristin Haglund, PhD, RN, FNP-BC, College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201 (email@example.com). Disclosure: The authors report no conflicts of interest. Advanced Emergency Nursing Journal: October/December 2019 - Volume 41 - Issue 4 - p 316-321 doi: 10.1097/TME.0000000000000266 Buy Metrics Abstract West Nile neuroinvasive disease (WNND) is a rare and severe manifestation of West Nile virus (WNV) infection that occurs in less than 1% of infected persons. It should be considered in patients who present with fever, neurological symptoms, and a history of recent outdoor activity where mosquitoes were active. This article highlights a case of a 55-year-old man whose history and symptoms of WNND were confounded with an alternate diagnosis, acute alcohol withdrawal. An overview of WNV infections, and important historical clues and objective findings characteristic of neuroinvasive disease, is discussed to increase readers' knowledge of WNV and awareness of when to consider WNND in the diagnostic differential. © 2019 Wolters Kluwer Health, Inc. All rights reserved.