Clinical case of herpetic encephalitis in a teenager with a history of tick bite on the background of comorbidity

Herpetic encephalitis (HE) accounts for 10-42% from the total number of viral encephalitis in the world with an incidence rate of up to 0.8 per 100 thousand populations. Mortality in HE without antiviral treatment is 60-70%, with the use of acyclovir it decreases to 15-20%. The infection occurs in all age groups, with one third of all cases occurring in children and teenagers. Aim - to raise the medical community's awareness of etiotropic treatment strategies by differentiating the etiological factor based on a clinical case. A clinical case of НE in a 17-year-old girl is presented, with a history of a tick bite against a background of chronic gastroduodenal and hepatobiliary pathology and emotional-volitional instability syndrome, where complaints of a dyspeptic and astheno-vegetative nature predominated at the onset of the disease. Immunological studies revealed IgG antibodies to Epstein-Barr virus, cytomegalovirus, IgM to herpes simplex virus types 1 and 2, Borrelia burgdorferi, immunoblotting for borreliosis - the result was questionable. Blood PCR for borreliosis - the result was negative. The lack of sufficient paraclinical criteria denied the diagnosis of borreliosis encephalitis, making it possible to focus on antiviral etiotropic therapy of herpetic infection. Conclusions. It is not always easy to identify an acute inflammatory process in the central nervous system as the cause of complaints of vomiting, headaches, and emotional and psychological discomfort in an older child. Comparison of the data of the anamnesis of life and disease with immunological examination played an important role in diagnosing the etiotropic pathogen of encephalitis. Herpes viruses of the first and second types cause massive brain lesions. Increasing the awareness of the medical community regarding the clinical features of the course of encephalitis in adolescents against the background of the risk of infection with other pathogens and the presence of somatic chronic pathology with emotional and psychological problems will contribute to the timely appointment of etiotropic treatment and prevention of the development of complications. The study was conducted according to the principles of the Helsinki Declaration. Informed consent was obtained from the patient for the study. The authors declare no conflict of interest.