Extraneurological Presentations of Tick‐Borne Encephalitis Virus: A Rare Case of TBEV‐Associated Myocarditis With Fever and Bicytopenia and a Systematic Literature Review

Purpose Tick‐borne encephalitis (TBE), a zoonotic disease caused by the tick‐borne encephalitis virus (TBEV), usually manifests with a biphasic course with neurological involvement during its second phase. Extraneurological manifestations are rare but clinically relevant. Methods We report a case of a 77‐year‐old patient with suspected acute myocarditis associated with central European TBEV infection and summarize the literature on extraneurological TBEV manifestations through a systematic review. Results The case of a 77‐year‐old patient with suspected acute myocarditis associated with central European TBEV infection is reported and discussed. Literature analysis identified 23 publications reporting extraneurological TBEV manifestations, including (peri)myocarditis, myositis, hematological abnormalities, and elevated transaminases. Conclusion TBEV infection can be complicated by myocarditis and should therefore be considered in the differential diagnosis in areas where TBEV is endemic in a patient with risk factors for tick bites. Vaccination remains crucial for preventing TBEV infections.