Original scientific paper

Prognosis of severity of tick-borne encephalitis based on selected parameters

Ljiljana Mišić Majerus ; Djelatnost za infektivne bolesti, Opća bolnica
Oktavija Đaković-Rode ; Odjel za virologiju Klinike za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Eva Ružić-Sabljić ; Institut za mikrobiologiju i imunologiju Medicinskog fakulteta Sveučilišta u Ljubljani, Ljubljana, Slovenija
Nevenka Bujić ; Djelatnost za infektivne bolesti, Opća bolnica
Vesna Mađarić ; Djelatnost za infektivne bolesti, Opća bolnica
Gordana Kolarić ; Djelatnost za infektivne bolesti, Opća bolnica

Abstract

The main purpose of our study was to investigate whether the severity and course of acute illness in patients with tick-borne encephalitis can be predicted based on selected parameters determined on admission to hospital. This retrospective study included adult patients with TBE, who were treated at the Department of Infectious Diseases, General Hospital, Koprivnica, Croatia, between 1995 and 2005. Case records of all patients were reviewed. On admission to hospital the acute meningoencephalitic (ME) stage was classified as mild or severe, depending on the presence of meningeal symptoms, the severity of clinical signs of encephalitis and presence of focal central nerves systems (CNS) signs. The patients were generally examined and categorized by the same physician. We analyzed and compared selected parameters determined on admission to hospital including: sex and age, multiple tick bite, seasonal distribution, period of time (days) between the onset of first symptoms of disease and the first examination, duration of asymptomatic interval (days), state of mind, course of illness (biphasic, monophasic), cerebrospinal fluid and peripheral blood findings, concomitant infection with Borrelia burgdorferi sensu lato (BBSL). All data collected from patients were entered into specially prepared questionnaire. Recent infection with TBE was confirmed in 133 patients, 83 (62,4%) males and 50 (37,6%) females, aged 16 to 76. A history of tick-bite was noted in 86 (64,6%) of whom multiple in 33 (38,3%) patients. TBE presented as isolated meningitis in 50 (37,6%), as ME in 66 (49,6%) and as meningoencephalomyelitis (MEM) in 17 (12,8%) patients. A biphasic course of disease occurred in 94 (70,7%) patients. Mild ME stage was noticed in 77 (57,8%) and severe in 56 (42,1%) patients. On admission to hospital only a short period of time between finishing initial stage and beginning of second ME stage (p<0,001), altered consciousness (p<0,001), elevated total protein concentration in CSF (p=0,009), peripheral blood leukocytosis (p=0,009) and elevated ESR (p=0,002) might indicate an unfavorable course of TBE. Other parameters investigated in this study did not correlate with the severity of the illness. Further investigations of more reliable parameters are needed in order to predict the severity of TBE.

Keywords

Tick-borne encephalitis; disease course

Hrčak ID:

59785

URI

https://hrcak.srce.hr/59785

Publication date:

31.3.2010.

Article data in other languages: croatian

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