REVIEW – March 2013

Many faces of tick-borne encephalitis

Authors: Anne Kallaste, Mari Petersen, Reili Rebane, Sandra Ütt, Siiri-Merike Lüüs, Riina Vibo, Janika Kõrv

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Tick-borne encephalitis (TBE) is an acute disease which presents itself in a diverse manner. Although named encephalitis, the nervous system is affected only in 20–30% of the patients. In the presence of typical clinical symptoms, the diagnosis of TBE is confirmed by specific antibodies in the blood and/or cerebrospinal f luid. Usually, TBE is not a severe disease. However, in serious cases prompt correct diagnosis and intensive care are important.

The aim of this study was to give an overview of TBE and the principles of diagnosis and treatment based on patient case analysis from Tartu University Hospital.

The retrospective study included 267 cases from Tartu University Hospital over a period of 11 years (2000–2010). The history of tick bite was known in 61% of the cases and TBE was the initial diagnosis in 89% of the cases. The most common symptoms were fever (97%) and headache (92%). In the majority of the patients, the disease presented itself as meningitis (62%) or meningoencephalitis (25%). In 50% of the cases, specific antibodies (both IgM and IgG) were found in the serum. The diagnosis was confirmed with cerebrospinal fluid (CSF) antibodies in 41% of the cases. Co-infection with Lyme’s disease occurred in 15 (5%) patients.