Cerebrospinal fluid findings and their temporal pattern in patients with different clinical presentations of tick-borne encephalitis : a cohort study

Bogovič, Petra (avtor), Kastrin, Andrej (avtor), Trampuš-Bakija, Alenka (avtor), Strle, Franc (avtor)

Objectives: There is a lack of systematic data on cerebrospinal fluid (CSF) findings in the different clinical manifestations of tick-borne encephalitis (TBE) and according to the duration of neurological involvement. This study aims to evaluate and compare routine CSF parameters in TBE patients presenting with meningitis, meningoencephalitis, or meningoencephalomyelitis, and to assess temporal changes in CSF during the first 10 days after the onset of neurological symptoms. Methods: We analysed 15 CSF parameters in 717 consecutive adult patients hospitalized for TBE at the Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia. Among these patients, 230 (32%) had meningitis, 446 (62%) meningoencephalitis, and 41 (6%) meningoencephalomyelitis. Results: CSF findings differed significantly among the three clinical presentations. Leukocyte count, neutrophil proportion, protein levels, immunoglobulin concentrations (IgM, IgG, IgA), and intrathecal synthesis quotients were highest in meningoencephalomyelitis and lowest in meningitis. These differences remained largely significant after adjusting for confounding factors. CSF abnormalities were detectable from day one of neurological symptoms, peaked around days 4–5, and then stabilized or showed mild improvement. Neutrophils predominated during the first two days, followed by a predominance of lymphocytes and monocytes from day 3 onward. This pattern was consistent in meningitis and meningoencephalitis but less pronounced in meningoencephalomyelitis. Conclusions: Clinical manifestations of TBE exhibit distinct CSF profiles. Abnormalities are most pronounced in meningoencephalomyelitis and least in meningitis. These alterations appear early, peak within the first days, and then stabilize or improve, although this pattern is less predictable in meningoencephalomyelitis.

• Jezik: Angleški jezik
• Ključne besede: tick-borne encephalitis, meningitis, meningoencephalitis, meningoencephalomyelitis, cerebrospinal fluid
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2026
• Št. strani: Str. 729–740
• Številčenje: Vol. 54, iss. 2
• PID: 20.500.12556/RUL-184252
• UDK: 616.9
• ISSN pri članku: 1439-0973
• DOI: 10.1007/s15010-025-02700-y
• COBISS.SI-ID: 259088643
• Datum objave v RUL: 02.07.2026

Gradivo je del revije

• Naslov: Infection
• Skrajšan naslov: Infection
• Založnik: Springer Nature
• ISSN: 1439-0973
• COBISS.SI-ID: 513677337

Licence

• Licenca: CC BY-NC-ND 4.0, Creative Commons Priznanje avtorstva-Nekomercialno-Brez predelav 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by-nc-nd/4.0/deed.sl
• Opis: Najbolj omejujoča licenca Creative Commons. Uporabniki lahko prenesejo in delijo delo v nekomercialne namene in ga ne smejo uporabiti za nobene druge namene.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: klopni meningoencefalitis, možganska tekočina, meningitis, meningoencefalitis, meningoencefalomielitis

Projekti

• Financer: ARIS - Javna agencija za znanstvenoraziskovalno in inovacijsko dejavnost Republike Slovenije
• Številka projekta: P3-0296
• Naslov: Bolezni in povzročitelji, ki jih v Sloveniji prenašajo členonožci