Abstract
Abstract
We report on a 5-year-old girl with an unusually severe course of tick-borne encephalitis following passive immunization with specific hyperimmune globulin after a tick bite in an endemic area. Serial investigations of the CSF revealed intrathecal production of specific antibodies paralleled by increasing numbers of B-cells after initial T-cell pleocytosis. Focal central lesions were evident on MRI.
Conclusion
The severity of the presented case questions the benefit of passive immunization and rather justifies consideration of vaccine recommendation to residents and travellers to areas endemic for tick-borne encephalitis virus.
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Abbreviations
- ICU :
-
intensive care unit
- TBE :
-
tick-borne encephalitis
- TBEV :
-
tick-borne encephalitis virus
References
Aebi C, Schaad UB (1994) FSME-Immunglobulin — eine kritische Beurteilung der Wirksamkeit. Schweiz Med Wochenschr 124:1837–1840
Cruse RP, Rethner AD, Ehrenberg G (1979) Central European tick-borne encephalitis: an Ohio case with a history of foreign travel. Am J Dis Child 9: 63–66
Goerre S, Kesselring J, Hartmann K, Kuhn M, Reinhart WH (1993) Neurologische Nebenwirkungen nach Impfung gegen die Frühsommer-Meningo-Enzephalitis. Schweiz Med Wochenschr 123:654–657
Gold R, Wiethölter H, Rihs I, Löwer J, Kappos L (1992) Frühsommer Meningoenzephalitis-Impfung. Dtsch Med Wochenschr 117:112–116
Grubbauer HM, Dornbusch HJ, Spork D, Zobel G, Trop M, Zenz W (1992) Tick-borne encephalitis in a 3-month-old-child. Eur J Pediatr 151:743–744
Harasek G (1974) Zeckenencephalitis im Kindesalter. Dtsch Med Wochenschr 99:1965–1970
Heinz F, Kunz CH, Fauma H (1980) Preparation of a highly purified vaccine against tick-borne encephalitis by continuous flow zonal ultracentrifugation. J Med Virol 6:213–221
Heinz FX, Röhrig IT (1990) Flaviviruses. In: Van Regenmortel MHV, Neurath AR (eds) Immunochemistry of viruses II. Elsevier, Amsterdam, pp 290–305
Kluger G, Schöttler A, Waldvogel K, Nadal D, Hinrichs W, Wündisch GF, Laub MC (1995) Tickborne encephalitis despite specific immunoglobulin prophylaxis. Lancet 346:1502
Köck T, Stünzner D, Freidle W, Pierer K (1992) Zur Klinik der Frühsommer-menigoencephalitis (FSME) in der Steiermark. Nervenarzt 63:205–208
Krech U, Jung F, Jung M (1969) Zentraleuropäische Zeckenencephalitis in der Schweiz. Schweiz Med Wochenschr 99:282–285
Kuhn M, Frutiger A, De Torrente A, Fitting JW (1992) Frühsommer-meningoencephalitis (FSME): Eine seltene Ursache für eine schwere, reversible neuro-muskuläre Ateminsuffizienz. Schweiz Med Wochenschr [Suppl] 44:2675
Kuntzer T, De Marval F, Ochsner F, De Torrenté A, Kuhn M, Fitting IW (1995) Méningo-encephalo-myélo-radiculité à flavivirus: parésie bi-brachiale et insuffisisance respiratoire. Schweiz Med Wochenschr 125:634–638
Kunz C, Hoffmann H, Stary A (1976) Feldversuche mit einem Impfstoff gegen Frühsommer Meningoencephalitis (FSME). Zentralbl Bakteriol Hyg 234:141–144
Kunz C, Hoffmann H, Kundi M, Mayer K (1981) Zur Wirksamkeit von FSME Immunglobulin. Wiener Klin Wochenschr 93:665–667
Lennette EH (1992) Laboratory diagnosis of viral infections. Marcel Dekker Inc., New York
Mamoli B, Pelzl G (1990) Residualschäden nach FSME. Oesterr Aerzteztg 45:45–51
Monath TP (1990) Flaviviruses. In: Fields BN, Knip DM, et al (eds) Virology, 2nd edn. Raven Press, New York, p 772
Morens DM (1994) Antibody-dependent enhancement of infection and the pathogenesis of viral disease. Clin Infect Dis 19:500–512
Morse RP, Bennish ML, Darras BT (1992) Eastern equine encephalitis presenting with a focal brain lesion. Pediatr Neurol 8:473–475
Piliero PJ, Brody J, Zamani A, Deresiewicz RL (1994) Eastern equine encephalitis presenting as focal neurora-diographic abnormalities: case report and review. Clin Infect Dis 18:985–988
Roggendorf M, Girgschies OE, Rosenkranz G (1994) Epidemiologie und Prophylaxe der Frühsommer-Meningoencephalitis 1994. Die gelben Hefte 34:74–80
Schneider H (1931) Ueber epidemische akute Meningitis serosa. Wien Klin Wochenschr 44:350
Scholz E, Wiethölter H (1987) Postvakzinale Schwerpunktneuritis nach prophylaktischer FSME-Impfung. Dtsch Med Wochenschr 112:544
Whitley RJ (1990) Viral encephalitis. N Engl J Med 4:242–250
Wiethölter H (1993) Prophylaxe der Frühsommer-Meningoenzephalitis. Dtsch Med Wochenschr 118:1133
Wyler R, Matile H (1984) Zecken-encephalitis in der Schweiz. Schweiz Rundsch Med (Praxis) 73:601–617
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Waldvogel, K., Bossart, W., Huisman, T. et al. Severe tick-borne encephalitis following passive immunization. Eur J Pediatr 155, 775–779 (1996). https://doi.org/10.1007/BF02002905
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DOI: https://doi.org/10.1007/BF02002905