Sandfly fever virus, serotype Toscana (TOS), is endemic in some Medite
rranean countries and causes sandfly fever (pappataci fever). In some
patients, TOS may cause meningitis and meningoencephalitis. We report
on two German adults returning from Italy with TOS-related meningitis,
complicated in one case by abducens nerve palsy. TOS infection should
be considered as a cause of acute central nervous system disorders in
patients returning from areas of endemicity.