{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:29:23Z","timestamp":1787020163470,"version":"build-2736575974"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the 2022 mpox-outbreak most patients presented with mild symptoms. Central nervous system (CNS) involvement has previously been described as a rare and severe complication of mpox; however, diagnostic findings in cerebrospinal fluid (CSF) analysis and neuroimaging studies have only been reported in one case previously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a previously healthy 37-year-old man with mpox complicated by encephalitis. He first presented with painful skin lesions and genital ulcers; polymerase chain reaction (PCR) from the lesions was positive for mpox. Twelve days later he was admitted with fever and confusion. Neuroimaging and CSF analysis indicated encephalitis. The CSF was PCR-negative for monkeypox virus but intrathecal antibody production was detected. He spontaneously improved over a few days course and recovered fully.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case of mpox-associated encephalitis shows that CNS involvement in mpox infection may have a relatively mild clinical course, and that detection of intrathecal antibody production can be used to establish the diagnosis if CSF monkeypox virus-PCR is negative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-024-09000-0","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T13:01:28Z","timestamp":1705410088000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Monkeypox virus-associated meningoencephalitis diagnosed by detection of intrathecal antibody production"],"prefix":"10.1186","volume":"24","author":[{"given":"Hansen","family":"Karin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e5tshake","family":"Ylva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6derholm","family":"Sandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pettke","family":"Aleksandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rkman","family":"Per","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sond\u00e9n","family":"Klara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"9000_CR1","unstructured":"European Centre for Disease Prevention and Control\/WHO Regional Office for Europe. Monkeypox JEo 12 October, 2022."},{"issue":"36","key":"9000_CR2","doi-asserted-by":"publisher","first-page":"2200620","DOI":"10.2807\/1560-7917.ES.2022.27.36.2200620","volume":"27","author":"AM Vaughan","year":"2022","unstructured":"Vaughan AM, Cenciarelli O, Colombe S, Alves de Sousa L, Fischer N, Gossner CM, et al. A large multi-country outbreak of monkeypox across 41 countries in the WHO European Region, 7 March to 23 August 2022. Eurosurveillance. 2022;27(36):2200620.","journal-title":"Eurosurveillance"},{"issue":"8","key":"9000_CR3","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1056\/NEJMoa2207323","volume":"387","author":"JP Thornhill","year":"2022","unstructured":"Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, et al. Monkeypox Virus infection in humans across 16 countries - April-June 2022. N Engl J Med. 2022;387(8):679\u201391.","journal-title":"N Engl J Med"},{"key":"9000_CR4","doi-asserted-by":"crossref","unstructured":"Badenoch JB, Conti I, Rengasamy ER, Watson CJ, Butler M, Hussain Z et al. Neurological and psychiatric presentations associated with human monkeypox virus infection: a systematic review and meta-analysis. EClinicalMedicine. 2022:101644.","DOI":"10.1016\/j.eclinm.2022.101644"},{"issue":"10","key":"9000_CR5","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1086\/425039","volume":"190","author":"JJ Sejvar","year":"2004","unstructured":"Sejvar JJ, Chowdary Y, Schomogyi M, Stevens J, Patel J, Karem K, et al. Human monkeypox infection: a family cluster in the midwestern United States. J Infect Dis. 2004;190(10):1833\u201340.","journal-title":"J Infect Dis"},{"issue":"6","key":"9000_CR6","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1016\/j.therap.2020.03.001","volume":"75","author":"G Kalmi","year":"2020","unstructured":"Kalmi G, Javeri F, Vanjak A, Kirren Q, Green A, Jarrin I, et al. Drug-induced meningitis: a review of the literature and comparison with an historical cohort of viral meningitis cases. Therapie. 2020;75(6):605\u201315.","journal-title":"Therapie"},{"issue":"10","key":"9000_CR7","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1111\/ene.13356","volume":"24","author":"P Taba","year":"2017","unstructured":"Taba P, Schmutzhard E, Forsberg P, Lutsar I, Lj\u00f8stad U, Mygland \u00c5, et al. EAN consensus review on prevention, diagnosis and management of tick-borne encephalitis. Eur J Neurol. 2017;24(10):1214\u2013e61.","journal-title":"Eur J Neurol"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09000-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-024-09000-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09000-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T13:01:52Z","timestamp":1705410112000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-024-09000-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,16]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["9000"],"URL":"https:\/\/doi.org\/10.1186\/s12879-024-09000-0","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,16]]},"assertion":[{"value":"11 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent to publish this case report have been obtained from the patient. Documentation available upon request. All identifying information has been removed from this manuscript and figures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from the patient to publish this case report in an online open-access publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"94"}}