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TBE Meningococcal Disease Influenza Smallpox

  Mixed Infections

Co-infections involving various combinations of pathogens are frequently described, and some tend to be particularly severe. Diseases caused by mixed TBE virus-Borrelia infections have already been revealed in several countries of Central Europe. Co-infection with Borrelia burgdorferi is reported in about 15% of patients on the basis of seropositive results in serum and/or CSF. In the majority of patients with concomitant infection the clinical features at presentation were characteristic of, or consistent with, TBE. It is suggested that in confirmed cases of tick-encephalitis in patients with acute lymphocytic meningitis or meningoencephalitis, originating in TBE and Lyme borreliosis endemic regions, an additional infection with Borrelia should be considered since if present the latter can be successfully treated with antibiotics. There is some information in the literature that co-infection with B. burgdorferi sensu lato might contribute to a more severe course of TBE. Similar findings of mixed infections are described in children, most commonly TBE and Lyme borreliosis. Double infections occur more frequently in areas where I. persulcatus ticks are abundant. A study from the Czech Republic demonstrated that TBE/HGE (human granulocytic ehrlichiosis) co-infections can also be encountered in Central Europe.

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