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Diagnosis of acute deer tick virus encephalitis.

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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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