An observational study in Tick Bites, Encephalitis and Meningitis, sponsored by Central Hospital, Nancy, France. Enrolling by invitation at 1 site in France. Per ClinicalTrials.gov, last updated 2025-09-22.
Sponsored by Central Hospital, Nancy, France · Observational
Tick-borne encephalitis (TBE) is a viral infection transmitted by ticks. TBE is the third most common cause of encephalitis in France. Across France, numerous cases of lymphocytic meningitis remain without a definitive diagnosis, notably at the Nancy University Hospital. The objective of this study is to assess the impact of a change in diagnostic practice on the work-up of undocumented lymphocytic meningitis and meningoencephalitis at Nancy University Hospital.
Tick-borne encephalitis (TBE) is a viral infection transmitted by ticks. It is an emerging infectious disease and has been notifiable in France since 2021. TBE is the third most common cause of encephalitis in France, following herpes simplex virus and varicella-zoster virus infections (ENCEIF data).
According to initial data collected by Santé publique France, eastern France is the most affected region, with over half of the reported cases occurring in the Rhône-Alpes and Alsace regions. However, this infection remains relatively unfamiliar to many clinicians and is infrequently investigated during routine diagnostic procedures.
Across France, numerous cases of lymphocytic meningitis remain without a definitive diagnosis, notably at the Nancy University Hospital, where approximately 150 such cases are recorded annually. It is plausible that a proportion of these cases are secondary to TBE infection.
The hypothesis underlying this study is based on these observations. Diagnostic practices at the Nancy University Hospital are currently evolving. The infectious diseases team is actively working to increase clinicians' awareness of TBE, encouraging them to consider this diagnosis when presented with compatible clinical scenarios. Specifically, in cases suggestive of TBE, the infectious diseases team now routinely recommends testing for this pathogen.
This change in practice may lead to an increased rate of documented TBE cases and potentially improve patient management.
The primary objective of this study is to assess the impact of this change in diagnostic practice on the work-up of undocumented lymphocytic meningitis and meningoencephalitis at Nancy University Hospital.
125 studies on the registry are indexed under Encephalitis; 33 are open to participants now.
This study's planned enrollment of 200 is below the median of 300 across 54 observational studies indexed under Encephalitis.
Browse Encephalitis studies →Central Hospital, Nancy, France is the lead sponsor of 798 studies on the registry; 186 are open to participants now.
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Inclusion Criteria:
Exclusion Criteria:
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Exclusion Criteria:
We are examining a change in clinical practice within our institution. Prior to this change, testing for tick-borne encephalitis (TBE) was not routinely performed in cases of meningitis and meningoencephalitis. Following the implementation of the new protocol, our infectious diseases team now recommends that all clinicians managing patients with compatible clinical presentations conduct TBE serology. The patient cohort described here corresponds to the period preceding this change in practice.
We are examining a change in clinical practice within our institution. Prior to this change, testing for tick-borne encephalitis (TBE) was not routinely performed in cases of meningitis and meningoencephalitis. Following the implementation of the new protocol, our infectious diseases team now recommends that all clinicians managing patients with compatible clinical presentations conduct TBE serology. The patient cohort described here corresponds to the period following this change in practice.
Other: Recommendation from the infectious diseases team
No commercial product was evaluated in this study. We are assessing the benefits and consequences of a change in clinical practice implemented at the hospital level. At our institution, it is now recommended that TBE serology be performed in all cases of undocumented meningitis or meningoencephalitis. The infectious diseases team at our hospital simply advises the clinicians responsible for patient care to perform this test.
TBE diagnosis
To measure the impact of revised diagnostic procedures on TBE detection among cases of unexplained clear-fluid meningitis and meningoencephalitis at Nancy University Hospital.
Time frame: This study compares data from the pre-intervention period (2022-2024) with that from the post-intervention period (2024-2026).
Plan to share: Undecided — The datasets generated and analysed during the current study are not publicly available due to restrictions by the French law, but are available from the last author on reasonable request at the following email address: b.lefevre@chru-nancy.fr.
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Central Hospital, Nancy, France →