ArticleThe American journal of case reports2021
"Double Trouble": Severe Meningoencephalitis Due to Borrelia burgdorferi and Powassan Virus Co-Infection Successfully Treated with Intravenous Immunoglobulin.
Article in The American journal of case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 10 citations in OpenAlex.
- A case study of Powassan virus encephalitis in an immunocompromised host.ASM case reports · 2026Article
- Steroid Refractory and Plasma Exchange Partially Responsive Longitudinally Extensive Transverse Myelitis Due to Tumor Necrosis Factor-Alpha (Etanercept): A Case Report.Clinics and practice · 2026Article
- Cerebral vasculitis as a severe complication of acute infectious meningoencephalitis-a case series of five different pathogens.Wiener medizinische Wochenschrift (1946) · 2025Article
- Powassan Virus Encephalitis in an Immunocompromised Patient: A Diagnostic Challenge With Case Report and Literature Review.Case reports in infectious diseases · 2025Article
- Meta-analysis of tick-borne and other pathogens: Co-infection or co-detection? That is the question.Current research in parasitology & vector-borne diseases · 2024Review
- Powassan Virus Infections: A Systematic Review of Published Cases.Tropical medicine and infectious disease · 2023Review
- Tick-Borne Encephalitis Virus: A Comprehensive Review of Transmission, Pathogenesis, Epidemiology, Clinical Manifestations, Diagnosis, and Prevention.Microorganisms · 2023Review
- The Consumption of Raw Goat Milk Resulted in TBE in Patients in Poland, 2022 "Case Report".Pathogens (Basel, Switzerland) · 2023Article
- Powassan Virus Encephalitis.Infectious disease clinics of North America · 2022Review
- Human Co-Infections betweenPathogens (Basel, Switzerland) · 2022Review
- A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus.Therapeutic advances in infectious diseaseReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND Powassan virus (POWV) is an emerging tick-borne flavivirus transmitted to humans by ticks. While infection is asymptomatic in some people, others develop life-threatening encephalitis with high mortality rates. Co-infection between POWV and Borrelia burgdorferi is rare despite the fact that both pathogens can be transmitted through the same tick vector, Ixodes scapularis. It is unclear if co-infection leads to more severe clinical presentation and worse outcome. CASE REPORT A 76-year-old Wisconsin man was admitted for meningoencephalitis complicated by hypoxemic and hypercapnic respiratory failure requiring endotracheal intubation. The patient had no known tick bites but lived in a heavily wooded area. Extensive work-up for infectious, autoimmune, and paraneoplastic causes was positive for Borrelia burgdorferi and Powassan virus infection (POWV). Following treatment with ceftriaxone for neuroborreliosis and supportive care for POWV infection, the patient failed to improve. Intravenous immunoglobulins (IVIG) were started empirically, and the patient attained gradual neurological improvement and was successfully extubated. CONCLUSIONS Treatment for POWV infection is supportive, and at this time there are no approved targeted antivirals for this disease. At this time, it remains unclear if co-infection with 2 pathogens leads to a more severe clinical presentation and higher mortality. In the absence of contraindications, IVIG might be beneficial to patients with POWV infection who are not improving with supportive care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.