Patient with severe fever with thrombocytopenia syndrome virus infection and central nervous system disturbance in Dongy
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CASE REPORT
Open Access
Patient with severe fever with thrombocytopenia syndrome virus infection and central nervous system disturbance in Dongyang, Zhejiang Province, China, 2017 Yi Sun1†, Bin Guo2†, Hao Yan1, Ai Lan Wu2, Wen Wu Yao1, Kang Chen2, Jun Hang Pan1, Zhao Xia Li3, Hai Yan Mao1 and Yan Jun Zhang1*
Abstract Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever that was first described in China in 2011. We report a patient who died of Severe fever with thrombocytopenia syndrome virus (SFTSV) infection, with a rapidly progressive central nervous system (CNS) disturbance, in Dongyang, Zhejiang Province, China, in 2017. Case presentation: A 64-year-old man was admitted to hospital after 4 days of fever. SFTSV was detected 1 day after the patient was admitted to hospital. The patient presented with CNS disturbance and died 4 days after admission. Detailed clinical and epidemiological investigations and laboratory tests were conducted. Reduced platelet, white blood cell, lymphocyte, and neutrophil counts, elevated lactate dehydrogenase, creatine kinase, aspartate aminotransferaseand alanine aminotransferase concentrations, and an increased activated partial thromboplastin time were observed. In a phylogenetic analysis, the isolate clustered close to a strain derived from South Korea. Conclusions: This is the first case of SFTSV infection with CNS disturbance in Dongyang, Zhejiang Province, China. The surveillance of suspected cases of SFTS is important in SFTSV endemic regions. Keywords: Severe fever with thrombocytopenia syndrome virus, Central nervous system disturbance, Clinical characteristic, Epidemiological feature, Phylogenetic
Background Severe fever with thrombocytopenia syndrome virus (SFTSV) poses serious public health concerns globally because it causes tick-borne hemorrhagic fever with a high case fatality rate (12–50%) [1–3]. Many cases of SFTSV infection have been confirmed in Zhejiang Province, China, since its first comprehensive description in 2011 [1, 4]. Fever, thrombocytopenia, leukocytopenia, and multi-organ dysfunction have been reported in SFTSVinfected patients. Several studies have reported patients who presented with rapidly progressive disturbances of the central nervous system (CNS), such as a human* Correspondence: [email protected] † Yi Sun and Bin Guo contributed equally to this work. 1 Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, Zhejiang, China Full list of author information is available at the end of the article
encephalitis-like syndrome [5–7]. Here, we report a random case of SFTSV infection presenting with humanencephalitis-like syndrome in 2017. To the best of our knowledge, this is the first case of SFTS with CNS involvement reported in Zhejiang Province, China. Our objectives were to understand (1) the clinical human-encephalitislike syndrome and the epidemiological and virological characteristics of this case; (2) the importance of the surveillance of suspected cases o
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