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Diagnosis of acute deer tick virus encephalitis.

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By El Khoury MY, Hull RC, Bryant PW, Escuyer KL, St George K, Wong SJ, Nagaraja A, Kramer L, Dupuis AP, Purohit T, Shah T, Wormser GP • www.ProHealth.com • February 1, 2013


Abstract

BACKGROUND: Deer tick virus (DTV) is a tick-borne flavivirus that has only recently been appreciated as a cause of viral encephalitis. We describe the clinical presentation of a patient who had DTV encephalitis diagnosed before death and survived for 8 months despite severe neurologic dysfunction.

METHODS: Diagnosis was made from a cerebrospinal fluid specimen, using a flavivirus-specific polymerase chain-reaction assay followed by sequence confirmation, and the phylogeny was analyzed. Serologic testing, including plaque reduction neutralization testing, was also performed.

RESULTS: Molecular analysis indicated that the virus was closely related to 2 strains of DTV that had been detected in Ixodes scapularis ticks from Massachusetts in 1996 and in the brain of a patient from New York in 2007.

CONCLUSIONS: DTV encephalitis should be considered in the differential diagnosis of encephalitis in geographic areas that are endemic for Lyme disease.

Clin Infect Dis. 2013 Feb;56(4):e40-7. doi: 10.1093/cid/cis938. Epub 2012 Nov 19. Case Reports; Research Support, U.S. Gov't, P.H.S.





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