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Chapter 5: TBE in adults

intracerebral pressure and a decreasing References
cerebral perfusion, therapeutic hypothermia
might be considered. High fever is associated
1. Kaiser R. Frühsommermeningo- enzephalitis.
with increased metabolic consumption.
Nervenarzt. 2016;87:667-80.
Antipyretics, or other physical measures like
cooling blankets, or infusion of cooled fluids, 2. Bogovic P, Strle F. Tick-borne encephalitis: A
should be employed to reduce body review of epidemiology, clinical characteristics,
temperature effectively. The use of steroids is and management. World J Clin Cases.
still a matter of debate and cannot be 2015;3:430.
recommended based on current evidence. 8,72
Dehydration increases the risk for cerebral 3. ECDC. Epidemiological situation of tick-borne
infarction. Severe TBE is often accompanied by encephalitis in the European Union and Europe
Free Trade Association countries. ECDC
hypovolemia due to a decreased intake and a
technical report. 2012.
secondary loss of fluids. Hyponatremia is a
common condition in patients with TBE, 4. Czupryna P, Moniuszko A, Pancewicz SA,
including the syndrome of inappropriate
Grygorczuk S, Kondrusik M, Zajkowska J. Tick-
antidiuretic hormone secretion (SIADH), borne encephalitis in Poland in years 1993-
cerebral salt-wasting syndrome, and reduced 2008–epidemiology and clinical presentation.
sodium supplementation. Mental and A retrospective study of 687 patients. Eur J
behavioral disturbances, delirium, and Neurol. 2011;18:673- 9.
psychotic signs and symptoms may justify
treatment with neuroleptics. For seizures, the 5. Lipowski D, Popiel M, Perlejewski K, et al. A
administration of benzodiazepines is recom- Cluster of Fatal Tick-borne Encephalitis Virus
Infection in Organ Transplant Setting. J Infect
mended. Pain and arousal cause intracranial
pressure peaks by increasing the cerebral Dis. 2017; 215:896-901.
blood flow; therefore, sedatives and careful 6. Zajkowska J, Czupryna P, Pancewicz S, et al.
clinical monitoring are key factors in the Fatal outcome of tick-borne encephalitis – a
prevention of intracranial hypertension. case series. Neurol Neurochir Pol. 2011;45:402-
Rehabilitation should be introduced as soon as 6.
possible, as early introduction of rehabilitation
therapy is essential to protect muscle atrophy. 7. Pikelj F, Tomazic J, Maticic M, Socan M,
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Contact: johannes.borde@web.de
8. Mickienė A, Laiškonis A, Günther G, Vene S,

Lundkvist Å, Lindquist L. Tickborne Encephalitis
Citation: in an Area of High Endemicity in Lithuania:
Borde JP, Zajkowska J. TBE in adults. Chapter Disease Severity and Long‐Term Prognosis. Clin
Infect Dis. 2002;35:650-8.
5. In: Dobler G, Erber W, Bröker M, Schmitt HJ,
eds. The TBE Book. 2nd ed. Singapore: Global
9. Palus M, Vojtíšková J, Salát J, et al. Mice with
Health Press; 2019. doi: 10.33442/978-981-14-
different susceptibility to tick-borne
0914-1_5 encephalitis virus infection show selective
neutralizing antibody response and
inflammatory reaction in the central nervous
system. J Neuroinflammation. 2013;10.

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