Ticks transmit not only Lyme disease: A case report of tick-borne encephalitis

Abstract

A 6-year-old girl was admitted to the Department of Paediatrics for the diagnostic work-up of a condition presenting as fever accompanied by headaches, nausea and vomiting. Approximately 4 weeks before hospital admission the child was bitten by two ticks. Five days later, fever and general ill-feeling developed, and the girl was diagnosed with a viral infection. After 12 days, fever recurred, and the child's condition worsened. The diagnostic work-up included lumbar puncture. Neuroborreliosis was excluded, and meningitis caused by the tick-borne encephalitis virus was diagnosed. The prevalence of tick-borne encephalitis in the general population is estimated at 0.51 case per 100,000 people. In most cases, the disease has a mild course. Serious complications develop in 25-50% of patients, and the mortality rate reaches 5%. Since approximately 40-50% of patients with laboratory-confirmed presence of the virus causing tick-borne encephalitis do not report being bitten by a tick, clinicians should consider the possibility of encountering the disease in their practice. Tick-borne encephalitis carries the risk of serious complications. There is no causal treatment available once infected, but the disease can be prevented by vaccination, with efficacy exceeding 95%.