Severe tick-borne encephalitis following passive immunization.
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.


CONCLUSIONS
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.
Waldvogel
K
K
Universitätskinderklinik, Zürich, Switzerland.
Bossart
W
W
Huisman
T
T
Boltshauser
E
E
Nadal
D
D
D002675:Child, Preschool; D004669:Encephalitis Viruses, Tick-Borne / Q000302:isolation & purification; D004675:Encephalitis, Tick-Borne / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*; D005260:Female; D006801:Humans; D007116:Immunization, Passive / Q000009:adverse effects*; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D007075:Immunoglobulin M / Q000097:blood / Q000134:cerebrospinal fluid; D007159:Immunologic Tests; D008279:Magnetic Resonance Imaging
D007074:Immunoglobulin G; D007075:Immunoglobulin M