RESUMO
A 56-year-old man was admitted to hospital with complaints of headache, fever and photophobia, 3 weeks after being bitten by ticks in Southern Germany. Two weeks before admission he had experienced a short period of a flu-like illness, from which he spontaneously recovered. Based on the tick bites in Southern Germany and the biphasic course of the illness shortly afterwards, we made the diagnosis tick-borne encephalitis, Frühsommer-Meningoenzephalitis in German (FSME). The diagnosis was confirmed serologically. FSME is caused by a flavivirus, which is transmitted via tick bites. In 72-87% of cases the course is biphasic. The virus subtype and the degree of central nervous system involvement determine the prognosis. The patient may experience residual symptoms. The treatment is symptomatic. Active immunisation offers protection, but is only recommended to those who stay frequently or for a long period in areas where the virus is endemic.
