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[Severe course of tick-borne encephalitis (Encephalomeningomyelitis): a case report]

Jolanta D Ostrowska1, Joanna Zajkowska, Waldemar Krupa

  • 1Kliniki Chorób Zakaźnych i Neuroinfekcji Akademii Medycznej w Białymstoku jolanta_ostrowska@o2.pl

Medycyna Pracy
|June 20, 2006
PubMed

Insights

A tick bite led to neuroinvasive Tick-Borne Encephalitis (TBE) in a student, causing neurological deficits. Prompt treatment improved symptoms, but residual weakness and nystagmus persisted, highlighting TBE

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Neurology

Background:

  • Tick-Borne Encephalitis (TBE) is a significant neurological infection transmitted by ticks, particularly prevalent in certain European and Asian regions.
  • Early diagnosis and management are crucial for mitigating severe neurological sequelae associated with TBE virus infection.

Observation:

  • A 19-year-old male presented with symptoms suggestive of encephalomeningitis following a tick bite.
  • Clinical manifestations included altered consciousness, headache, vomiting, meningeal signs, cranial nerve palsies (VII, XI), nystagmus, ptosis, and limb weakness.
  • Cerebrospinal fluid analysis revealed lymphocytic pleocytosis and TBE virus antibodies; neuroimaging (CT, MRI) was unremarkable.

Findings:

  • The patient experienced generalized convulsions and developed significant neurological deficits, including peripheral nerve palsies and muscle atrophy.
  • Treatment led to a reduction in neurological abnormalities, although residual symptoms such as nystagmus, ptosis, and shoulder girdle muscle weakness persisted.
  • Antibodies against TBE virus in cerebrospinal fluid confirmed the diagnosis in the context of characteristic clinical and neurological findings.

Implications:

  • This case underscores the potential for TBE to cause severe neuroinvasive disease even in young, otherwise healthy individuals.
  • The persistence of neurological deficits highlights the importance of long-term monitoring and rehabilitation for TBE patients.
  • The absence of findings on neuroimaging despite significant neurological symptoms emphasizes the need for clinical and laboratory diagnostics in TBE diagnosis.

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