Jamestown Canyon virus-mediated meningoencephalitis with unusual laboratory findings.

Jamestown Canyon virus (JCV) is a mosquito-borne orthobunyavirus that causes an acute febrile illness, meningitis or meningoencephalitis. Human infections in the USA are rare. A 59-year-old man was admitted with fever, headache and hallucinations and required transfer to intensive care due to worsening agitation. Lumbar puncture was significant for neutrophilic pleocytosis, low glucose and high protein. Cerebral spinal fluid (CSF) bacterial cultures were negative, however, the CSF analysis via ELISA returned positive for JCV IgM. Plaque reduction neutralisation tests on a serum sample revealed IgM for JCV with titres of 1:160, which confirmed the diagnosis of JCV meningoencephalitis as the titres for other arboviruses were low. The patient improved significantly with supportive care. Our case highlights an atypical laboratory presentation of neutrophilic pleocytosis on CSF in a viral meningoencephalitis and draws attention to the potential cross-reactivity with other arboviruses.

Fatal Direct Current Electrocution in a Welder.

Direct current (DC) electrocution is exceedingly rare, especially in the context of workplace accidents and exposure, where electrical fatality is almost exclusively associated with alternating current (AC). The DC electrocution requires a much higher voltage to cause significant injury and death, and therefore is generally considered safer than AC. Here, we present a case of DC electrocution where a welder accidentally electrocuted himself while repairing a metal plate inside a silo. The decedent had complained of feeling shocks in his arm while welding twice before being electrocuted. Autopsy revealed minimal trauma, along with a classic targetoid electrical burn and punctate lesions likely to be electrical burns. Correlation of the history obtained at the scene and the examination performed at autopsy aided the identification of this rare cause of death.