Table. Diagnostic tests performed on the probable case of tick-borne encephalitis (TBE) during hospitalisation, Germany, July–August 2019.
| Date (2019) | Test (sample type/assay) | Result | Interpretation |
|---|---|---|---|
| 17–19 Jula | CSF diagnostics | 1,000 cells (norm: 0–5) (40% granulocytes, 60% lymphocytes) 1.5 g protein 59 mg/dL glucose level (norm: 40–80) |
Inflammation |
| 17–19 Jula | Blood culture | Negative | Normal |
| 17–19 Jula | CSF culture | Negative | Normal |
| 17–19 Jula | Multiplex PCR (CSF) for: -Escherichia coli, -Haemophilus influenzae, -Listeria monocytogenes, -Neisseria meningitidis, -Streptococcus, -Cytomegalovirus, -Enterovirus, -Herpes Simplex Virus 1 and 2, -Human herpesvirus 6, -Human parechovirus, -Varicella zoster virus, -Cryptococcus |
Negative | Normal |
| 17–19 Jula | Enterovirus (stool) | Negative | Normal |
| 20 Jul | MRSA and MRGN screening | Negative | Normal |
| 23 Jul | TBEV-IgG (serum)b | 10.3 AE/mL | Positive (cut-off: 0.241) |
| 23 Jul | TBEV-IgM (serum)b | 12.5 index | Positive (cut-off: 0.234) |
| 25 Jul | Borrelia burgdorferi (IgG-ELISA) | < 5.2 U/mL | Negative (cut-off: < 7 U/mL) |
| 22 Jul and 25 Jul | Electroencephalography | Slowed activity in right hemisphere; Epileptic activity in right temporal/central and left occipital areas. |
Pathological |
| 01 Aug | Magnetic resonance imaging | Leptomeningeal enhancement. No sign of parenchymal defect or brain abscess. |
Pathological |
CSF: cerebrospinal fluid; MDRGN: multidrug resistant Gram-negative bacteria; MRSA: methicillin-resistant Staphylococcus aureus; TBEV: tick-borne encephalitis virus.
a Performed during the first hospital stay. Exact test dates were not given in discharge summary.
b The test kit used was Enzygnost Anti-TBE virus (IgG, IgM) (Siemens, Marburg, Germany) which determines a specific cut-off for each run (alpha-method).