Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • fatigue
  • general malaise
  • headache
  • body pains
  • nausea
  • mild meningitis
  • severe encephalitis
  • altered mental state

Other diagnostic factors

  • cranial and spinal nerve palsies
  • vestibular/hearing defects
  • seizures
  • paresis
  • arms, shoulders, and head muscles paralysis

Risk factors

  • history of recent tick bite
  • summer months
  • occupational exposure
  • outdoors activities
  • recent consumption of raw (unpasteurised) milk or dairy products
  • age ≥50 years
  • bioterrorism

Diagnostic investigations

1st investigations to order

  • FBC
  • ESR
  • CRP
  • LFTs
  • CT brain
  • CSF analysis
  • CSF/serum serology
Full details

Investigations to consider

  • CSF/serum reverse-transcription polymerase chain reaction (RT-PCR)
  • MRI head
  • EEG
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Ashley M. Croft

School of Pharmacy and Biomedical Science

University of Portsmouth

Portsmouth

UK

Disclosures

AMC declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant Infectious Diseases Physician

The James Cook University Hospital

Middlesbrough

UK

Disclosures

JW declares that he has no competing interests.

Medical Director

Your Excellent Health Service

Honorary Lecturer

UCL

London

UK

Disclosures

CE runs a private travel clinic.

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