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Early Summer Meningoencephalitis: Unusual yet Usual Diagnostic Challenge in a Geriatric Patient-A Case Report
Georgiana Ciobanu1,2, Daniel Pichler1,3, Benjamin Hutter1,4
1Geriatric Clinic, Cantonal Hospital of St. Gallen, Health Ostschweiz Ostschweiz, 9007 St. Gallen, Switzerland.
Abstract:
Background and Clinical Significance: When diverse clinical presentations coincide with complex laboratory findings, particularly in older adults, the diagnostic process can be especially challenging. Case Presentation: We report the case of a geriatric patient who was hospitalized with initial gastrointestinal and respiratory symptoms, followed by progressive chest pain and profound weakness, accompanied by elevated transaminases, troponin elevation, and hyponatremia, initially suggesting multiple competing diagnostic entities. During the clinical course, the patient developed neurological symptoms. Ultimately, careful history-taking, including detailed exposure assessment, raised suspicion for tick-borne encephalitis, which was subsequently confirmed by serological testing. Conclusions: This case highlights the diagnostic complexity of tick-borne encephalitis in older adults, where atypical and multisystem presentations may obscure the underlying etiology and delay recognition of a neuroinfectious disease.
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