Pediatric tick-borne infections of the central nervous system in an endemic region of Sweden: a prospective evaluation of clinical manifestations

Sundin, Mikael; Hansson, M; Engman, Mona-Lisa; Örvell, Claes; Lindquist, Lars; Wide, Katarina; Lidefelt, Karl-Johan

doi:10.1007/s00431-011-1542-2

Cited by 34 publications

(16 citation statements)

References 27 publications

(46 reference statements)

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“…The large proportion of children do present with meningitis followed by meningoencephalitis. Children with meningoencephalomyelitis and radiculitis did form only a minor subgroup [15,18]. It appears from these studies that one fourth of all children will present with moderate to severe symptoms initially.…”

Section: Prognosismentioning

confidence: 94%

“…Cases that involve the white matter of the central nervous system (CNS) including the brainstem and myelon are on record but are exceedingly rare [16][17][18]. Two recent studies from Sweden showed that TBE in children can present also as a nonspecific inflammatory disease with a restricted encephalitic profile compared to adults making the diagnosis difficult in selected cases [17,19].…”

Section: Introductionmentioning

confidence: 99%

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Tick-borne encephalitis in children

Kevin

2012

Wien Med Wochenschr

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This review is a summary of the most important clinical findings and implications of tick-borne encephalitis (TBE) in children. It is based on a Pubmed search with the terms "tick-borne encephalitis", "children", "infection", "meningitis", "meningoencephalitis", and "outcome". TBE in children shares several features with their adult counterpart but has overall a better prognosis. Nevertheless, TBE is associated with substantial morbidity and mortality in a small group of children and seems to cause cognitive dysfunctions, which needs to be studied in further detail.

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Section: Prognosismentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Tick-borne encephalitis in children

Kevin

2012

Wien Med Wochenschr

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“…Die FSME verläuft bei Kindern und Jugendlichen häufig unspezifisch mit den Symptomen eines grippalen Infektes und somit gutartiger [20,21]. In den letzten Jahren häufen sich jedoch auch Berichte über langwierige neurologische Funktionsstörungen bei Kindern [11, 22 -34].…”

Section: Leitsymptomeunclassified

Frühsommer-Meningoenzephalitis (FSME)

et al. 2017

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Zusammenfassung Die Fr?hsommer-Meningoenzephalitis (FSME) ist eine durch ein gleichnamiges Virus verursachte akute Entz?ndung des Nervensystems. Reservoir f?r die FSME-Viren sind Kleintiernager des Waldes und der Wiesen und selten auch Ziegen, was die r?umliche Begrenzung von Endemiegebieten erkl?rt (?Naturherde?). Die FSME-Viren werden haupts?chlich durch Zecken ?bertragen, gelegentlich aber auch durch Produkte aus nicht pasteurisierter Ziegenmilch. Infektionen k?nnen das gesamte Jahr ?ber erfolgen, die meisten Erkrankungen treten jedoch in den Hochsommermonaten auf. Mehr als 90?% der Infektionen erfolgen w?hrend der Freizeit. Dennoch ist die FSME eine typische Berufserkrankung von Land- und Forstwirten. Bei ca. 70?% der Patienten manifestiert sich die FSME mit einem zweigipfligen Fieberverlauf. Nach einer Inkubationszeit von 5???28 Tagen entwickeln die Patienten zun?chst ein allgemeines Krankheitsgef?hl, Kopfschmerzen und Fieber (Prodromalphase). Nach vor?bergehender Besserung markiert dann ein erneuter Fieberanstieg wenige Tage sp?ter den Beginn der zweiten Krankheitsphase. Diese manifestiert sich in ca. 50?% der F?lle als isolierte Meningitis, in 40?% als Meningoenzephalitis und in 10?% als Meningoenzephalomyelitis. H?ufig finden sich quantitative und qualitative Bewusstseinsst?rungen und eine Ataxie. Das fr?hzeitige Auftreten von Schluck- und Sprechst?rungen, L?hmungen der Gesichts- und Halsmuskulatur sowie einer Ateml?hmung weist auf eine ung?nstige Prognose hin. Die FSME verl?uft bei Kindern und Jugendlichen h?ufig unspezifisch mit den Symptomen eines grippalen Infektes und somit gutartiger als bei Erwachsenen. Mit zunehmendem Alter ist nicht nur der Verlauf gravierender, auch steigt die Zahl der Defektheilungen. Die Diagnose basiert auf der Anamnese mit Aufenthalten in einem Risikogebiet, der neurologischen Symptomatik mit deutlicher Beeintr?chtigung des Allgemeinbefindens, dem positiven Nachweis von FSME-spezifischen IgM- und IgG-Antik?rpern im Blut und einer Pleozytose im Liquor. Es existiert keine kausale Therapie, die Behandlung erfolgt symptomatisch. Vor der Erkrankung kann man sich durch eine aktive Immunisierung gut sch?tzen. Die Impfung wird allen Personen empfohlen, die sich wiederholt in einem Risikogebiet aufhalten.

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“…In children and adolescents, TBE is often nonspecific with symptoms of a flu infection and is thus more benign than in adults [20,21]. In recent years, however, there have been reports of children with protracted neurological dysfunction [11,[22][23][24][25][26][27][28][29][30][31][32][33][34].…”

Section: Principal Symptomsmentioning

confidence: 99%

Tick-borne Encephalitis (TBE)

Kaiser

Archelos-Garcia

Jilg³

et al. 2017

Neurology International Open

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Tick-borne encephalitis (TBE) is an acute inflammation of the nervous system caused by a virus of the same name. Reservoirs for the TBE viruses are small rodents of the forest and meadows and rarely also goats, which explains the spatial limitation to endemic areas ("natural foci"). TBE virus is transmitted mainly by ticks, but occasionally also by products from non-pasteurized goat's milk. Infections can occur throughout the year, but most of the diseases present during the high summer months. More than 90% of infections occur during leisure time. However, it is a typical occupational disease for farmers and foresters. In approximately 70% of the patients, TBE manifests itself with a two-phase fever course.After an incubation period of 5–28 days, the patients first develop a general feeling of illness, headaches and fever (prodromal phase). After a temporary improvement, a new episode of fever marks the beginning of the second phase of the disease a few days later. This is manifested in about 50% of the cases as isolated meningitis, in 40% as meningoencephalitis and in 10% as meningoencephalomyelitis. Frequently, there are quantitative and qualitative disturbances of consciousness and ataxia. The early onset of swallowing and speech disturbances, paralysis of the facial and throat muscles as well as the need for assisted ventilation indicates an unfavorable prognosis. In children and adolescents, TBE is often unspecific with the symptoms of a flu infection and thus more benign than in adults. With age, not only the course is more serious, but also the number of residual deficits increases.The diagnosis is based on history with stays in a risk area, the neurological symptoms with marked impairment of the general condition, the demonstration of TBE-specific IgM and IgG antibodies in the blood and a pleocytosis in the CSF. No specific treatment for TBE is known so far, but TBE can be successfully prevented by active immunization. Vaccination is recommended for all persons who stay repeatedly in a risk area.

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Pediatric tick-borne infections of the central nervous system in an endemic region of Sweden: a prospective evaluation of clinical manifestations

Abstract: Pediatric tick-borne CNS infections are unexpectedly common and should be considered in children with unspecific and unexplained acute CNS-related symptoms.

Cited by 34 publications

References 27 publications

Tick-borne encephalitis in children

Tick-borne encephalitis in children

Frühsommer-Meningoenzephalitis (FSME)

Tick-borne Encephalitis (TBE)

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