Diagnosis of Acute Deer Tick Virus Encephalitis

Authors

Marc Y. El Khoury, New York Medical CollegeFollow
Rene C. Hull
Patrick W. Bryant
Kay L. Escuyer
Kirsten St George
Susan J. Wong
Aarathi Nagaraja
Laura Kramer
Alan P. Dupuis
Treta Purohit
Tushar Shah
Gary P. Wormser, New York Medical CollegeFollow

Author Type(s)

Faculty

DOI

10.1093/cid/cis938

Journal Title

Clinical Infectious Diseases

First Page

e40

Last Page

7

Document Type

Article

Publication Date

2-1-2013

Department

Medicine

Disciplines

Infectious Disease | Medicine and Health Sciences

Abstract

BACKGROUND: Deer tick virus (DTV) is a tick-borne flavivirus that has only recently been appreciated as a cause of viral encephalitis. We describe the clinical presentation of a patient who had DTV encephalitis diagnosed before death and survived for 8 months despite severe neurologic dysfunction. METHODS: Diagnosis was made from a cerebrospinal fluid specimen, using a flavivirus-specific polymerase chain-reaction assay followed by sequence confirmation, and the phylogeny was analyzed. Serologic testing, including plaque reduction neutralization testing, was also performed. RESULTS: Molecular analysis indicated that the virus was closely related to 2 strains of DTV that had been detected in Ixodes scapularis ticks from Massachusetts in 1996 and in the brain of a patient from New York in 2007. CONCLUSIONS: DTV encephalitis should be considered in the differential diagnosis of encephalitis in geographic areas that are endemic for Lyme disease.

Recommended Citation

El Khoury, M. Y., Hull, R. C., Bryant, P. W., Escuyer, K. L., St George, K., Wong, S. J., Nagaraja, A., Kramer, L., Dupuis, A. P., Purohit, T., Shah, T., & Wormser, G. P. (2013). Diagnosis of Acute Deer Tick Virus Encephalitis. Clinical Infectious Diseases, 56 (4), e40-7. https://doi.org/10.1093/cid/cis938