A lethal tick-borne encephalitis from an active endemic area in Slovakia.

Tick-borne encephalitis (TBE) is a neglected zoonotic neuroinvasive disease. Most cases of TBE have a mild course, but some patients with encephalitis develop long-term neurological or neuropsychic sequelae. We report a fatal case of TBE in a patient living in an endemic area. The case occurred in a middle-aged man with no epidemiological evidence of tick bites, no consumption of raw dairy products, and who was not vaccinated against TBE. The aim of this paper is to draw attention to the need for better information of the risk factors associated with TBE with the long-term sequelae, to improve case management and to stimulate the development of new vaccination strategies. To our knowledge, this is the first reported case of rare fatal TBE in a middle-aged man with no severe comorbidities in Slovakia.