Toscana virus encephalitis with reversible self-limiting vasculopathy.

Area of Science:

• Neurology
• Infectious Diseases
• Virology

Background:

• Toscana virus is an arbovirus transmitted by sandflies, prevalent in the Mediterranean but rare in the UK.
• While often asymptomatic, Toscana virus can cause severe neurological manifestations, including encephalitis and vasculopathy.

Purpose of the Study:

• To report a case of Toscana virus encephalitis and vasculopathy in an elderly traveler.
• To highlight the diagnostic methods and clinical presentation of this rare neuroinvasive infection.

Main Methods:

• Diagnosis confirmed via real-time reverse transcriptase-polymerase chain reaction (RT-PCR) on cerebrospinal fluid (CSF).
• Serological testing showing a rise in antibody titres in serum.

Main Results:

• The patient, an elderly man returning from a Mediterranean cruise, developed Toscana virus encephalitis.
• The encephalitis was associated with vasculopathy, leading to multiple ischemic strokes and reversible intravascular stenosis.

Conclusions:

• Toscana virus infection should be considered in travelers presenting with febrile illness and confusion after visiting endemic areas.
• Early diagnosis and symptomatic treatment are key for managing Toscana virus infections, particularly neuroinvasive forms.