Patient 6 is a 62-year-old man from the town of Mandal who was bitten by a tick; onset of symptoms began 2 weeks later. At the end of May, the patient was dizzy and weak, had a headache, chills, and fever. He was hospitalized on June 11, 2002.
The antibody from serum sample profiles showed previous infection with herpes simplex and varicella zoster viruses. Borrelia antibodies could not be detected in serum samples taken at 5-week intervals. IgM antibodies against Mycoplasma pneumoniae were not detected, and virus cultures were negative. Nucleic acids from herpes simplex virus, varicella-zoster virus, or enterovirus were not detected in cerebrospinal fluid (CSF).
TBEV IgM and IgG antibodies were detected in serum samples, with high levels of IgM (optical density [OD] 1.580 on June 13 to OD 0.899 on July 18) and high IgG levels (13.06, OD 1.235 on June 13 to OD 1.742 on July 18). Cut-off values were 0.250 for IgM and 0.263 for IgG on June 13 and 0.271 for IgM and 0.278 for IgG on June 18. Neutralization test antibodies in serum samples rose from <5 in samples taken on June 13 to 10 in samples from July 18. Symptoms gradually disappeared, and the patient completely recovered in 2 months.