Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, avenue de France 15, 1002, Lausanne, Switzerland.
Department of Internal Medicine, Etablissements Hospitaliers du Nord Vaudois, 1400, Yverdon-les-Bains, Switzerland.
BMC Ophthalmol. 2021 Aug 28;21(1):315. doi: 10.1186/s12886-021-02068-1.
Tick-borne encephalitis (TBE) is an infectious disease of the central nervous system caused by the TBE virus (TBEV), which is usually transmitted by a tick-bite, with increasing incidence in northeastern Europe and eastern Asia during the past decade. Ocular involvement has not been described in the literature to date.
A 58-year-old patient presented to the emergency department with occipital headaches and poor balance for 5 days. He reported a tick-bite 6 weeks before without erythema migrans followed by a flu-like syndrome. Serological testing was negative for Borreliosis and TBEV. At presentation, he was febrile with neck stiffness and signs of ataxia. Three days later, he presented unilateral visual loss in his right eye. Examination revealed non granulomatous anterior uveitis, vitreous inflammation, and retinal haemorrhages at the posterior pole without macular oedema or papillitis. Polymerase chain reaction (PCR) of the cerebrospinal fluid returned negative for all Herpes family viruses. No clinical evidence of other infection nor malignancy was identified. A seroconversion of the TBEV- immunoglobulin titres was observed 2 weeks later while the serum antibodies for Borrelia were still not detected. Magnetic resonance imaging was unremarkable. We concluded to the diagnosis of TBE-related uveitis. Under supportive treatment, there was complete resolution of the neurological symptoms and the intraocular inflammation without sequelae within the following weeks.
We describe a new association of TBEV with uveitis. In view of the growing number of TBE cases and the potential severity of the disease we aim at heightening awareness to achieve prompt recognition, prevention, and treatment.
蜱传脑炎（TBE）是一种中枢神经系统传染病，由 TBE 病毒（TBEV）引起，通常通过蜱叮咬传播，在过去十年中，东欧和东亚的发病率不断上升。迄今为止，文献中尚未描述眼部受累。
一名 58 岁患者因枕部头痛和平衡不良 5 天就诊于急诊科。他报告称在 6 周前被蜱叮咬，没有游走性红斑，随后出现流感样综合征。血清学检测对莱姆病和 TBEV 均为阴性。就诊时，他发热，颈部僵硬，并有共济失调迹象。3 天后，他出现右眼单侧视力丧失。检查发现非肉芽肿性前葡萄膜炎、玻璃体炎症和后极视网膜出血，无黄斑水肿或视乳头炎。脑脊液聚合酶链反应（PCR）未检测到所有疱疹家族病毒。未发现其他感染或恶性肿瘤的临床证据。两周后，TBEV 免疫球蛋白滴度出现血清转换，而血清抗伯氏疏螺旋体抗体仍未检测到。磁共振成像无异常。我们诊断为 TBE 相关葡萄膜炎。在支持治疗下，神经症状和眼内炎症在接下来的几周内完全消退，无后遗症。
我们描述了 TBEV 与葡萄膜炎的新关联。鉴于 TBE 病例数量不断增加以及疾病的潜在严重性，我们旨在提高认识，以实现及时识别、预防和治疗。
