{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T20:15:25Z","timestamp":1781813725271,"version":"3.54.5"},"reference-count":31,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,11,20]],"date-time":"2022-11-20T00:00:00Z","timestamp":1668902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004488","name":"Croatian Science Foundation","doi-asserted-by":"publisher","award":["IP-2016-06-7456"],"award-info":[{"award-number":["IP-2016-06-7456"]}],"id":[{"id":"10.13039\/501100004488","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004488","name":"Croatian Science Foundation","doi-asserted-by":"publisher","award":["653316"],"award-info":[{"award-number":["653316"]}],"id":[{"id":"10.13039\/501100004488","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Union\u2019s Horizon 2020 research and innovation program","award":["IP-2016-06-7456"],"award-info":[{"award-number":["IP-2016-06-7456"]}]},{"name":"European Union\u2019s Horizon 2020 research and innovation program","award":["653316"],"award-info":[{"award-number":["653316"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibodies"],"abstract":"<jats:p>Flaviviruses are a heterogeneous group of viruses that may induce broad antigenic cross-reactivity. We present a patient who was admitted to the infectious disease department with symptoms suggestive of aseptic meningitis. During the clinical workup, the patient reported a tick bite two weeks before the disease onset. High titers of IgM and IgG antibodies to tick-borne encephalitis virus (TBEV) were found in both serum and cerebrospinal fluid (CSF) samples, indicating acute TBEV infection. West Nile virus (WNV) and Usutu virus (USUV) IgM and\/or IgG antibodies were also detected, and a virus neutralization test (VNT) was performed. A high titer of TBEV neutralizing (NT) antibodies (640) was detected, which confirmed acute TBE. However, NT antibodies to WNV and USUV were also detected (titer 80 for both viruses). After TBEV and WNV IgG avidity evaluation, previous flavivirus infection was highly suspected (avidity index 82% and 89%, respectively). Blood, CSF, and urine samples were negative for respective viruses\u2019 RNA. The presented case highlights the challenges in flavivirus serodiagnosis. In the published literature, different degrees of cross-reactivity or cross-neutralization between TBEV and dengue, louping ill, Omsk hemorrhagic fever, Langat, and Powassan virus were also observed. Therefore, the serology results should be interpreted with caution, including the possibility of cross-reactivity. In areas where several flaviviruses co-circulate VNT is recommended for disease confirmation.<\/jats:p>","DOI":"10.3390\/antib11040072","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T04:33:32Z","timestamp":1669005212000},"page":"72","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Cross-Reactive Antibodies in Tick-Borne Encephalitis: Case Report and Literature Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1877-5547","authenticated-orcid":false,"given":"Tatjana","family":"Vilibic-Cavlek","sequence":"first","affiliation":[{"name":"Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4917-9270","authenticated-orcid":false,"given":"Thomas","family":"Ferenc","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateja","family":"Vujica Ferenc","sequence":"additional","affiliation":[{"name":"Institute of Emergency Medicine of Krapina-Zagorje County, 49000 Krapina, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Bogdanic","sequence":"additional","affiliation":[{"name":"Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Potocnik-Hunjadi","sequence":"additional","affiliation":[{"name":"Department for Infectious Diseases, General Hospital Varazdin, 42000 Varazdin, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Sabadi","sequence":"additional","affiliation":[{"name":"Department for Infectious Diseases, Clinical Hospital Center Osijek, 31000 Osijek, Croatia"},{"name":"Medical Faculty, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0398-5346","authenticated-orcid":false,"given":"Vladimir","family":"Savic","sequence":"additional","affiliation":[{"name":"Laboratory for Virology and Serology, Poultry Center, Croatian Veterinary Institute, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5170-947X","authenticated-orcid":false,"given":"Ljubo","family":"Barbic","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Stevanovic","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7827-2642","authenticated-orcid":false,"given":"Federica","family":"Monaco","sequence":"additional","affiliation":[{"name":"Department of Virology, OIE Reference Center for West Nile Disease, Istituto Zooprofilattico Sperimentale \u201cG. Caporale\u201d, 64100 Teramo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddy","family":"Listes","sequence":"additional","affiliation":[{"name":"Laboratory for Diagnostics, Croatian Veterinary Institute, Veterinary Institute Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Savini","sequence":"additional","affiliation":[{"name":"Department of Virology, OIE Reference Center for West Nile Disease, Istituto Zooprofilattico Sperimentale \u201cG. Caporale\u201d, 64100 Teramo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,20]]},"reference":[{"key":"ref_1","unstructured":"(2022, October 31). Current ICTV Taxonomy Release. Available online: https:\/\/ictv.global\/taxonomy."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ruzek, D. (2011). Tick-Borne Encephalitis Virus: A General Overview. 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