Cargando…

Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland

Background: Ticks represent very important vectors of human and zoonotic pathogens, and tick-borne diseases (TBDs) are diagnosed with increasing frequency. Therefore, the aim of this retrospective study was to describe patients presenting with a complaint of tick bite in the emergency department (ED...

Descripción completa

Detalles Bibliográficos
Autores principales: Thalmann, Patrick, Ehrhard, Simone, Summerfield, Artur, Ricklin, Meret Elisabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037620/
https://www.ncbi.nlm.nih.gov/pubmed/36960968
http://dx.doi.org/10.3390/idr15020016
_version_ 1784911923200917504
author Thalmann, Patrick
Ehrhard, Simone
Summerfield, Artur
Ricklin, Meret Elisabeth
author_facet Thalmann, Patrick
Ehrhard, Simone
Summerfield, Artur
Ricklin, Meret Elisabeth
author_sort Thalmann, Patrick
collection PubMed
description Background: Ticks represent very important vectors of human and zoonotic pathogens, and tick-borne diseases (TBDs) are diagnosed with increasing frequency. Therefore, the aim of this retrospective study was to describe patients presenting with a complaint of tick bite in the emergency department (ED) of a large university hospital in Switzerland. Methods: Data were collected by searching for keywords in the routine clinic database to identify cases from 1 July 2012 to 30 June 2020. The patients’ data were screened for preexisting diseases and demographic and clinical characteristics. Results: We included 415 patients collected over a period of 8 years, with highest admission frequencies from May to July. Of these, 82% were outpatients, 15.9% admitted to a hospital ward, and five to intensive care. The patients were allocated to three groups. The first group represented patients with erythema chronica migrans (ECM), which is pathognomonic for Lyme borreliosis (n = 45). Accordingly, 89% of cases in this group of patients were treated with antibiotics. The second group represented patients with other tick bite-associated erythema (n = 139). In this group, no particular clinical symptoms or laboratory findings were found. Finally, the largest group represented patients in which the tick bite was no longer visible (n = 201). This group of patients had significantly more evidence of neurological disorders (52%) and were treated at a higher rate with non-steroidal anti-inflammatory (29%) or antiviral (13%) drugs. Although the vaccination status for tick-borne encephalitis virus (TBEV) was not systematically evaluated, at least 10% of the latter group was vaccinated, indicating another source for neurological disease. Furthermore, only 14% of the tested patients were positive for IgM or IgG against TBEV. Conclusion: This retrospective study indicates the presence of many undiagnosed neurological diseases following tick bites that could be caused by TBEV or an unknown infectious agent. Taken together, although tick bites were not very frequently seen in the present tertiary ED, the frequent presence of neurological symptoms demands a more systematic assessment of vaccination status and TBEV serology as well as further diagnostic evaluations in patients that report tick bites and neurological symptoms.
format Online
Article
Text
id pubmed-10037620
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100376202023-03-25 Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland Thalmann, Patrick Ehrhard, Simone Summerfield, Artur Ricklin, Meret Elisabeth Infect Dis Rep Article Background: Ticks represent very important vectors of human and zoonotic pathogens, and tick-borne diseases (TBDs) are diagnosed with increasing frequency. Therefore, the aim of this retrospective study was to describe patients presenting with a complaint of tick bite in the emergency department (ED) of a large university hospital in Switzerland. Methods: Data were collected by searching for keywords in the routine clinic database to identify cases from 1 July 2012 to 30 June 2020. The patients’ data were screened for preexisting diseases and demographic and clinical characteristics. Results: We included 415 patients collected over a period of 8 years, with highest admission frequencies from May to July. Of these, 82% were outpatients, 15.9% admitted to a hospital ward, and five to intensive care. The patients were allocated to three groups. The first group represented patients with erythema chronica migrans (ECM), which is pathognomonic for Lyme borreliosis (n = 45). Accordingly, 89% of cases in this group of patients were treated with antibiotics. The second group represented patients with other tick bite-associated erythema (n = 139). In this group, no particular clinical symptoms or laboratory findings were found. Finally, the largest group represented patients in which the tick bite was no longer visible (n = 201). This group of patients had significantly more evidence of neurological disorders (52%) and were treated at a higher rate with non-steroidal anti-inflammatory (29%) or antiviral (13%) drugs. Although the vaccination status for tick-borne encephalitis virus (TBEV) was not systematically evaluated, at least 10% of the latter group was vaccinated, indicating another source for neurological disease. Furthermore, only 14% of the tested patients were positive for IgM or IgG against TBEV. Conclusion: This retrospective study indicates the presence of many undiagnosed neurological diseases following tick bites that could be caused by TBEV or an unknown infectious agent. Taken together, although tick bites were not very frequently seen in the present tertiary ED, the frequent presence of neurological symptoms demands a more systematic assessment of vaccination status and TBEV serology as well as further diagnostic evaluations in patients that report tick bites and neurological symptoms. MDPI 2023-03-01 /pmc/articles/PMC10037620/ /pubmed/36960968 http://dx.doi.org/10.3390/idr15020016 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Thalmann, Patrick
Ehrhard, Simone
Summerfield, Artur
Ricklin, Meret Elisabeth
Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland
title Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland
title_full Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland
title_fullStr Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland
title_full_unstemmed Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland
title_short Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland
title_sort retrospective study of tick bites associated with neurological disease in a level three university hospital in switzerland
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037620/
https://www.ncbi.nlm.nih.gov/pubmed/36960968
http://dx.doi.org/10.3390/idr15020016
work_keys_str_mv AT thalmannpatrick retrospectivestudyoftickbitesassociatedwithneurologicaldiseaseinalevelthreeuniversityhospitalinswitzerland
AT ehrhardsimone retrospectivestudyoftickbitesassociatedwithneurologicaldiseaseinalevelthreeuniversityhospitalinswitzerland
AT summerfieldartur retrospectivestudyoftickbitesassociatedwithneurologicaldiseaseinalevelthreeuniversityhospitalinswitzerland
AT ricklinmeretelisabeth retrospectivestudyoftickbitesassociatedwithneurologicaldiseaseinalevelthreeuniversityhospitalinswitzerland