Dexamethasone in Tick-borne Encephalitis

Inclusion Criteria: * age 18 years or older and * clinical signs and symptoms of meningoencephalitis or meningomyelitis and * cerebrospinal pleocytosis and * serological confirfmation of tick-borne encephalitis virus infection Exclusion Criteria: * pregnancy or * severe neurological impairment befor tick-borne encephalitis or * systemic corticosteroid treatment in the past 30 days or * allergy to corticosteroids or * immunosuppresive condition or therapy such as HIV with CD4 \< 200/ml, organ or bone marrow transplant, receiving chemotherapy, radiotherapy or any other immunosuppresive therapy, primary immunodeficiency, hematological maliganncy or * ventricular shunt or * endoscopically documented peptic gastric ulcer in the past six months or gastrointestinal bleeding with hemoglobin drop ≥ 20 units or * uncontrolled diabetes with hyperglicemia or * antiviral therapy with rilpivirin