Toscana Virus (TOSV) Meningitis in Two Travelers in Southeastern Spain

Two Irish tourists, a 72-year-old male and his 60-year-old wife, developed symptoms of meningoencephalitis after traveling to Spain. Both complained of a holocranial headache, vomiting, and fevers. Toscana virus (TOSV) infection was diagnosed based on serology. Cultures and PCR were negative for other pathogens. Both blood (serum) and cerebrospinal fluid (CSF) samples were tested to diagnose TOSV infection. Specifically, CSF and serum samples were processed using real-time RT-PCR and ELISA serologic assays. Symptomatic treatment led to quick recovery and both patients were discharged from the hospital within 1 week. These cases highlight the importance of considering TOSV in the differential diagnosis of acute meningitis, especially in travelers to endemic regions. The lack of awareness among clinicians and specific screening recommendations may lead to underestimation of the TOSV incidence.