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European Journal of Pediatrics

, Volume 169, Issue 6, pp 767–769 | Cite as

Tick-borne encephalitis presenting as fever without localising signs—a case series

  • Patrick Michael Meyer
  • Hanspeter Zimmermann
  • Philippe Goetschel
Short Report

Abstract

Introduction

Tick-borne encephalitis (TBE) presents without neurologic symptoms in 19% in children less than 16 years in Switzerland (2000–2008). In these cases, fever can be the only leading manifestation.

Case series

We report on four hospitalised children who had TBE and presented as fever without localising signs (FWLS) between 2000 and 2008 in an endemic area in Switzerland.

Conclusion

TBE infection has to be considered in the differential diagnosis of FWLS in endemic areas. Foremost, FWLS characterised by a biphasic fever course and accompanied by headache in patients in a reduced general condition. Affirming that in patients presenting as FWLS also cases of TBE are contained, this disease is underreported.

Keywords

Tick-borne encephalitis (TBE) Fever without localising signs (FWLS) Children Switzerland 

References

  1. 1.
    Dumpis U, Crook D, Oksi J (1999) Tick-borne encephalitis. Clin Infect Dis 28:882–890CrossRefPubMedGoogle Scholar
  2. 2.
    Stähelin-Massik J, Zimmermann H, Gnehm HE (2008) Tick-borne encephalitis in Swiss children 2000–2004: five-year nationwide surveillance of epidemiologic characteristics and clinical course. Pediatr Infect Dis J 27:555–572CrossRefPubMedGoogle Scholar
  3. 3.
    Waddle E, Jhaveri R (2009) Outcomes of febrile children without localising signs after pneumococcal conjugate vaccine. Arch Dis Child 94:144–147CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Patrick Michael Meyer
    • 1
  • Hanspeter Zimmermann
    • 2
  • Philippe Goetschel
    • 1
  1. 1.Department of PaediatricsTriemli Hospital ZurichZurichSwitzerland
  2. 2.Division of Communicable DiseasesSwiss Federal Office of Public HealthBernSwitzerland

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