{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T08:43:41Z","timestamp":1782809021448,"version":"3.54.5"},"reference-count":10,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: When diverse clinical presentations coincide with complex laboratory findings, particularly in older adults, the diagnostic process can be especially challenging. Case Presentation: We report the case of a geriatric patient who was hospitalized with initial gastrointestinal and respiratory symptoms, followed by progressive chest pain and profound weakness, accompanied by elevated transaminases, troponin elevation, and hyponatremia, initially suggesting multiple competing diagnostic entities. During the clinical course, the patient developed neurological symptoms. Ultimately, careful history-taking, including detailed exposure assessment, raised suspicion for tick-borne encephalitis, which was subsequently confirmed by serological testing. Conclusions: This case highlights the diagnostic complexity of tick-borne encephalitis in older adults, where atypical and multisystem presentations may obscure the underlying etiology and delay recognition of a neuroinfectious disease.<\/jats:p>","DOI":"10.3390\/reports9030205","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T02:16:44Z","timestamp":1782699404000},"page":"205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Summer Meningoencephalitis: Unusual yet Usual Diagnostic Challenge in a Geriatric Patient\u2014A Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7013-3455","authenticated-orcid":false,"given":"Georgiana","family":"Ciobanu","sequence":"first","affiliation":[{"name":"Geriatric Clinic, Cantonal Hospital of St. Gallen, Health Ostschweiz Ostschweiz, 9007 St. Gallen, Switzerland"},{"name":"Regional Hospital La Carit\u00e0, 6600 Locarno, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8681-6200","authenticated-orcid":false,"given":"Daniel","family":"Pichler","sequence":"additional","affiliation":[{"name":"Geriatric Clinic, Cantonal Hospital of St. Gallen, Health Ostschweiz Ostschweiz, 9007 St. Gallen, Switzerland"},{"name":"Blood Donation Foundation Stiftung Blutspende Schweizerische Rote Kreuz Ostschweiz, 9000 St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Hutter","sequence":"additional","affiliation":[{"name":"Geriatric Clinic, Cantonal Hospital of St. Gallen, Health Ostschweiz Ostschweiz, 9007 St. Gallen, Switzerland"},{"name":"Medbase Friedtalweg, 9500 Wil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"M\u00fcnzer","sequence":"additional","affiliation":[{"name":"Geriatric Clinic, Cantonal Hospital of St. Gallen, Health Ostschweiz Ostschweiz, 9007 St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"key":"ref_1","unstructured":"Bundesamt f\u00fcr Gesundheit BAG (2026, June 16). Official Website\u2014Fr\u00fchsommer-Meningoenzephalitis. Available online: https:\/\/www.bag.admin.ch\/bag\/de\/home\/krankheiten\/krankheiten-im-ueberblick\/fsme.html."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1093\/cid\/cix319","article-title":"Epidemiology of Meningitis and Encephalitis in the United States, 2011\u20132014","volume":"65","author":"Hasbun","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_3","unstructured":"Robert Koch Institut (2026, June 16). Official Website\u2014Tick-Borne Encephalitis. Available online: https:\/\/gesund.bund.de\/en\/fruehsommer-meningoenzephalitis-fsme."},{"key":"ref_4","first-page":"261","article-title":"Autonomic involvement in tick-borne encephalitis (TBE): Report of five cases","volume":"11","author":"Kleiter","year":"2006","journal-title":"Eur. J. Med. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e00160","DOI":"10.1016\/j.parepi.2020.e00160","article-title":"Clinical and laboratory findings in tick-borne encephalitis virus infection","volume":"10","author":"Barp","year":"2020","journal-title":"Parasite Epidemiol. Control"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"430","DOI":"10.12998\/wjcc.v3.i5.430","article-title":"Tick-borne encephalitis: A review of epidemiology, clinical characteristics, and management","volume":"3","author":"Bogovic","year":"2015","journal-title":"World J. Clin. Cases"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1007\/s150100050050","article-title":"Comparison of the epidemiological and clinical features of tick-borne encephalitis in children and adults","volume":"28","author":"Logar","year":"2000","journal-title":"Infection"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"102306","DOI":"10.1016\/j.ttbdis.2023.102306","article-title":"Tick-borne diseases in the North Sea region-A comprehensive overview and recommendations for diagnostics and treatment","volume":"15","author":"Eikeland","year":"2024","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_9","first-page":"3051689","article-title":"Extraneurological Presentations of Tick-Borne Encephalitis Virus: A Rare Case of TBEV-Associated Myocarditis with Fever and Bicytopenia and a Systematic Literature Review","volume":"2026","author":"Seneghini","year":"2026","journal-title":"Case Rep. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Bohmwald, K., Andrade, C.A., G\u00e1lvez, N.M., Mora, V.P., Mu\u00f1oz, J.T., and Kalergis, A.M. (2021). The Causes and Long-Term Consequences of Viral Encephalitis. Front. Cell. Neurosci., 15.","DOI":"10.3389\/fncel.2021.755875"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/205\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T07:45:39Z","timestamp":1782805539000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,28]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["reports9030205"],"URL":"https:\/\/doi.org\/10.3390\/reports9030205","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,28]]}}}