{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T15:49:30Z","timestamp":1771602570768,"version":"3.50.1"},"reference-count":11,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>To investigate whether and how cerebrospinal fluid (CSF) findings can contribute to distinguish tick-borne encephalitis (TBE) from herpes simplex virus (HSV) and varicella zoster virus (VZV) induced central nervous system (CNS) infections (HSV-I, VZV-I). Chart review and identification of TBE, HSV- I, and VZV-I was carried out, fulfilling the following criteria: (1) clinical signs of encephalitis and\/or meningitis, (2) complete CSF analysis and confirmed viral etiology by either PCR or antibody testing in CSF, (3) hospitalized patients, and (4) available brain magnetic resonance imaging (MRI). Fifty-nine patients with 118 CSF\/serum pairs were included. These comprised 21 with TBE (35 CSF\/serum pairs), 20 (40 CSF\/serum pairs) with HSV-I, and 18 (43 CSF\/serum pairs) with VZV-I. In contrast to HSV-I and VZV-I, CSF cell differentiation in TBE showed more often an increased (&gt;20%) proportion of granulocytes (p &lt; 0.01) and a more frequent quantitative intrathecal IgM synthesis (p = 0.001 and p &lt; 0.01, respectively), while the second was even more pronounced when follow-up CSF analyses were included (p &lt; 0.001). CSF findings help to distinguish TBE from other viral infections. In cases with CSF pleocytosis and a positive history for a stay in or near an endemic area, TBE antibodies in CSF and serum should be determined, especially if granulocytes in CSF cell differentiation and\/or an intrathecal IgM synthesis is present.<\/jats:p>","DOI":"10.3390\/cells9102169","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T08:02:58Z","timestamp":1601280178000},"page":"2169","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Tick-Borne Encephalitis: A Differential Pattern of Intrathecal Humoral Immune Response and Inflammatory Cell Composition Compared with Other Viral CNS Infections"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2737-7495","authenticated-orcid":false,"given":"Makbule","family":"Senel","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Rapp","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Mayer","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Ulm University, 89075 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Jesse","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigurd D.","family":"S\u00fcssmuth","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4273-4267","authenticated-orcid":false,"given":"Markus","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Lewerenz","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayrettin","family":"Tumani","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Ulm, 89081 Ulm, Germany"},{"name":"Speciality Clinic of Neurology Dietenbronn, 88477 Schwendi, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1016\/S0140-6736(08)60800-4","article-title":"Tick-borne encephalitis","volume":"371","author":"Lindquist","year":"2008","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1093\/brain\/122.11.2067","article-title":"The clinical and epidemiological profile of tick-borne encephalitis in southern Germany 1994\u20131998. A prospective study of 656 patients","volume":"122","author":"Kaiser","year":"1999","journal-title":"Brain"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1111\/ene.13356","article-title":"EAN consensus review on prevention, diagnosis and management of tick-borne encephalitis","volume":"24","author":"Taba","year":"2017","journal-title":"Eur. J. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/S0140-6736(20)30040-4","article-title":"Detection of tick-borne encephalitis virus in the UK","volume":"395","author":"Holding","year":"2020","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1900658","DOI":"10.2807\/1560-7917.ES.2019.24.47.1900658","article-title":"Detection of new endemic focus of tick-borne encephalitis virus (TBEV), Hampshire\/Dorset border, England, September 2019","volume":"24","author":"Holding","year":"2019","journal-title":"Eurosurveillance"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1093\/cid\/cit458","article-title":"Case definitions, diagnostic algorithms, and priorities in encephalitis: Consensus statement of the international encephalitis consortium","volume":"57","author":"Venkatesan","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1093\/clinchem\/37.7.1153","article-title":"Quantification of Virus-Specific Antibodies in Cerebrospinal Fluid and Serum: Sensitive and Specific Detection of Antibody Synthesis in Brain","volume":"37","author":"Reiber","year":"1991","journal-title":"Clin. Chem."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1136\/jnnp.2009.195438","article-title":"The chemokine CXCL13 in acute neuroborreliosis","volume":"81","author":"Senel","year":"2010","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kennedy, P.G.E., Quan, P.L., and Lipkin, W.I. (2017). Viral encephalitis of unknown cause: Current perspective and recent advances. Viruses, 9.","DOI":"10.3390\/v9060138"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/S1473-3099(10)70222-X","article-title":"Causes of encephalitis and diff erences in their clinical presentations in England: A multicentre, population-based prospective study","volume":"10","author":"Granerod","year":"2010","journal-title":"Lancet Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1111\/j.1468-1331.2012.03808.x","article-title":"EFNS-ENS guidelines for the use of PCR technology for the diagnosis of infections of the nervous system","volume":"19","author":"Steiner","year":"2012","journal-title":"Eur. J. Neurol."}],"container-title":["Cells"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4409\/9\/10\/2169\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:13:46Z","timestamp":1760177626000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4409\/9\/10\/2169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,25]]},"references-count":11,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["cells9102169"],"URL":"https:\/\/doi.org\/10.3390\/cells9102169","relation":{},"ISSN":["2073-4409"],"issn-type":[{"value":"2073-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,25]]}}}