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TBE Meningococcal Disease Influenza Smallpox

  Laboratory Findings

Blood count: The typical changes in blood count in TBE are as follows: With the onset of the meningoencephalitic stage, leukopaenia – which is observed during the first stage of the disease and the asymptomatic interval – disappears. It is followed by transient leukocytosis with leukocyte counts that are considerably higher than in other forms of viral meningitis (6,600–14,600/mm³). Usually, leukocytosis changes into leukopaenia before normalisation of the blood count is observed after some time. The blood sedimentation rate may be as high as 100mm/h. The frequency and the extent of abnormal values do not correlate with the diagnosis or prognosis of TBE. Elevated C-reactive protein is detected in more than 80% of the patients.

Cerebrospinal fluid: Pleocytosis (mainly lymphocytes) is observed in the cerebrospinal fluid, reaching maximum values of 5,000/mm³ cells. Frequently, cell counts of several hundred mm³, as well as protein values between 50–200mg/dl are observed. Usually it takes four to six weeks for the CSF lab parameter values to normalize, but in individual cases elevated values may persist for several months.

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