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Tick borne encephalitis without cerebrospinal fluid pleocytosis
Daša Stupica1, Franc Strle2, Tatjana Avšič-Županc3
1Department of Infectious Diseases, University Medical Center Ljubljana, Japljeva 2, 1525, Ljubljana, Slovenia. dasa.stupica@kclj.si.
BMC Infectious Diseases
|November 19, 2014
Summary
Tick borne encephalitis (TBE) can occur in the central nervous system without cerebrospinal fluid pleocytosis. This finding is crucial for diagnosing TBE in endemic regions, even without typical diagnostic markers.
Area of Science:
- Neurovirology
- Infectious Diseases
- Neurology
Background:
- Tick borne encephalitis (TBE) is a significant vector-borne central nervous system infection in Europe and Asia.
- The European subtype of TBE virus often presents with a biphasic clinical course, with neurological involvement in the second phase.
- Cerebrospinal fluid (CSF) pleocytosis is traditionally considered essential for diagnosing neurological TBE, confirmed by specific antibodies.
Observation:
- A case study from Slovenia, a TBE-endemic area, is presented.
- The patient exhibited encephalitis but lacked the expected cerebrospinal fluid pleocytosis.
- Central nervous system infection with TBE virus was confirmed in this patient.
Findings:
- Cerebrospinal fluid pleocytosis is not an absolute requirement for diagnosing encephalitis caused by tick borne encephalitis virus.
- The study demonstrates that TBE virus can cause central nervous system infection without CSF pleocytosis.
Implications:
- Diagnostic criteria for TBE may need re-evaluation, especially in endemic areas.
- Clinicians should consider TBE in patients with compatible neurological symptoms and tick exposure risk, irrespective of CSF findings.
- This broadens the diagnostic approach for tick borne encephalitis virus infections.
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