[Tick-encephalitis after a vacation in Southern Germany]

A 38-year-old man was admitted with signs of meningoencephalitis. Tick-borne encephalitis was considered because the patient reported a tick bite during a vacation in South Germany and because of the biphasic course of the symptoms. Serology for tick-borne encephalitis was positive: this constituted the first reported positive serology outcome in the National Institute for Public Health and Environment in the Netherlands. Tick-borne encephalitis is an infection with a flavivirus transmitted by an infected tick, which is endemic in parts of Central and Eastern Europe. The neurological symptoms are meningitis, meningoencephalitis or meningoradiculomyelitis. In a small percentage of patients neurological symptoms persist. A reliable vaccine is available, but is not routinely recommended for tourists.