Wengse Carl, Ericsson Jesper, Hallberg Susanna, Ursing Johan
Danderyds Sjukhus AB - Medicinkliniken Stockholm, Sweden - Stockholm, Sweden.
Danderyds Sjukhus AB - Infektionskliniken Stockholm, Sweden Danderyds Sjukhus AB - Infektionskliniken Stockholm, Sweden.
Lakartidningen. 2017 Jun 16;114:ELAI.
Rapid improvement of tick-borne encephalitis after treatment with corticosteroids Tick-borne encephalitis (TBE) is a viral disease transmitted by ticks. The virus is divided into three subtypes named Western, Siberian and Far Eastern TBE virus (TBEV). Western TBEV is endemic in parts of Europe and Sweden and typically causes a biphasic illness with influenza-like symptoms followed by neurological symptoms ranging from mild meningitis to severe meningoencephalitis and death. Despite an effective vaccine, TBE is increasing in Sweden and Europe. The pathogenesis of TBE is poorly understood; direct infection of neurons as well as immunological reactions mediated by T-cells have been implicated. In some endemic areas, such as Lithuania, patients with TBE are given corticosteroids based on the clinical experience that it results in rapid improvement. However, existing retrospective studies have failed to show beneficial effects of corticosteroids compared to symptomatic treatment in patients with TBE. This case report describes how an elderly man with meningoencephalitis and cranial nerve palsy due to TBE rapidly improved after administration of high dose corticosteroids.
皮质类固醇治疗后蜱传脑炎迅速改善 蜱传脑炎（TBE）是一种由蜱传播的病毒性疾病。该病毒分为三种亚型，即西方型、西伯利亚型和远东型蜱传脑炎病毒（TBEV）。西方型TBEV在欧洲部分地区和瑞典为地方性流行，通常引起双相性疾病，先是出现流感样症状，随后出现从轻度脑膜炎到严重脑膜脑炎甚至死亡的神经症状。尽管有有效的疫苗，但TBE在瑞典和欧洲的发病率仍在上升。TBE的发病机制尚不清楚；神经元的直接感染以及T细胞介导的免疫反应都被认为与之有关。在一些地方性流行地区，如立陶宛，根据临床经验，TBE患者会接受皮质类固醇治疗，因为这会带来快速改善。然而，现有的回顾性研究未能显示与对症治疗相比，皮质类固醇对TBE患者有有益效果。本病例报告描述了一名因TBE导致脑膜脑炎和颅神经麻痹的老年男性在给予高剂量皮质类固醇后迅速好转的情况。
