Tickborne encephalitis in an area of high endemicity in lithuania: disease severity and long-term prognosis.
Of 250 consecutively admitted patients with central nervous system (CNS) infections who were treated during a 1-year period, all 133 patients with tickborne encephalitis (TBE) were included in a prospective follow-up study. TBE presented as mild (meningeal) in 43.6% of patients and as moderate or severe (encephalitic) in 43.6% and 12.8% of patients, respectively. Paralytic disease was observed in 3.8% of the subjects, and cranial nerve injury was observed in 5.3%. One patient died of TBE. Permanent CNS dysfunction after 1 year was found in 30.8% of patients; in 8.5% of all TBE cases, severe disabilities required adjustment of daily activities. Corticosteroid treatment did not seem to improve outcome. A progressive course of TBE was noted in 2 patients. The risk of incomplete recovery was significantly higher among patients with the encephalitic form of TBE (odds ratio, 4.066; 95% confidence interval, 1.848-8.947). In conclusion, TBE is an important pathogen in CNS infection in the Kaunas region of Lithuania, and it causes long-lasting morbidity in one-third of cases.
Mickiene
Aukse
A
Clinic of Infectious Diseases, Kaunas University of Medicine, 3021 Kaunas, Lithuania. auske@kaunas.omnitel.net
Laiskonis
Alvydas
A
Günther
Göran
G
Vene
Sirkka
S
Lundkvist
Ake
A
Lindquist
Lars
L
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D004660:Encephalitis / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017282:Tick-Borne Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
D000305:Adrenal Cortex Hormones