Non-Surgical Management of Acute Appendicitis in the Presence of West Nile Encephalitis

Abstract

This case report describes the complex management of a 62-year-old immunocompromised male presenting with acute appendicitis and concurrent West Nile virus (WNV) meningoencephalitis. Initially treated conservatively with antibiotics for appendicitis, the patient's condition deteriorated due to neuroinvasive WNV, complicating clinical assessment and decision-making. Imaging confirmed acute appendicitis without progression, and antibiotic therapy was continued successfully despite impaired consciousness. This case highlights the challenges of managing intra-abdominal infections in patients with concurrent central nervous system involvement, emphasizing the need for multidisciplinary collaboration and the potential viability of non-surgical appendicitis treatment in select high-risk cases.