Pediatricians practicing in the United States may understandably be confused by the bewildering list of viruses associated with endemic arbovirus encephalitis infections that occur throughout the world. Visits to foreign countries provide exposure to these unusual infections and physicians will increasingly be encountering them. This was recently illustrated when a child in Ohio had a febrile, biphasic encephalopathic illness that was acquired during foreign travel. She had been exposed to ticks. Viral antibody titers confirmed a recent infection by a member of the tick-borne encephalitis (TBE) virus complex.
Report of a Case.—A 4-year-old girl was admitted to the Cleveland Clinic with ataxia, head-tilt, irritability, headache, elevated temperature, anorexia, and myalgia. Her medical history was unremarkable. Her family had recently returned from a vacation in Hungary. They had visited a region where TBE was known to be enzootic. While in Hungary, she first became ill with a temperature (40 °C),