Exploring corticosteroid therapy in tick-borne encephalitis: A case report and rationale for future research

Area of Science:

• Neuroscience
• Infectious Diseases
• Immunology

Background:

• Tick-borne encephalitis (TBE) is a significant central nervous system (CNS) infection caused by TBEV.
• No specific antiviral therapies are currently available for TBE.
• The use of corticosteroids for TBE remains controversial.

Observation:

• A 54-year-old male with biphasic TBE initially improved with high-dose dexamethasone.
• Clinical deterioration occurred upon steroid discontinuation, necessitating intensive care.
• Subsequent treatment with high-dose methylprednisolone led to rapid neurological improvement.

Findings:

• The patient's clinical course and CSF analysis suggest an immunopathological mechanism in TBE.
• T-cell mediated responses and cytokine-induced blood-brain barrier disruption may play a role.
• Corticosteroid administration was associated with reduced CNS inflammation.

Implications:

• This case supports the potential benefit of corticosteroids in managing severe TBE.
• Corticosteroids might mitigate neuroinflammation in TBE, similar to other neuroinflammatory conditions.
• Further research is warranted to clarify the role of immunomodulatory treatments in TBE.