A 60-year-old man with well-controlled HIV presented to a tertiary care center in Arizona 6 weeks after the abrupt onset of lower extremity weakness that had developed over 1 day and progressed to paraparesis. Imaging revealed diffuse abnormal ventral root enhancement of the cauda equina. Laboratory testing confirmed neuroinvasive West Nile virus infection causing flaccid paralysis. https://medicalwarehouses.shop/product-category/veterinary-supplies/