Cargando…
Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report
BACKGROUND: Severe fever with thrombocytopenia syndrome is an emerging infectious disease caused by a novel phlebovirus belonging to the family Bunyaviridate. Emergence of encephalitis/encephalopathy during severe fever with thrombocytopenia syndrome progression has been identified as a major risk f...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290612/ https://www.ncbi.nlm.nih.gov/pubmed/28153057 http://dx.doi.org/10.1186/s13256-016-1192-0 |
_version_ | 1782504666929561600 |
---|---|
author | Kaneko, Masahiko Maruta, Masaki Shikata, Hisaharu Asou, Kengo Shinomiya, Hiroto Suzuki, Tadaki Hasegawa, Hideki Shimojima, Masayuki Saijo, Masayuki |
author_facet | Kaneko, Masahiko Maruta, Masaki Shikata, Hisaharu Asou, Kengo Shinomiya, Hiroto Suzuki, Tadaki Hasegawa, Hideki Shimojima, Masayuki Saijo, Masayuki |
author_sort | Kaneko, Masahiko |
collection | PubMed |
description | BACKGROUND: Severe fever with thrombocytopenia syndrome is an emerging infectious disease caused by a novel phlebovirus belonging to the family Bunyaviridate. Emergence of encephalitis/encephalopathy during severe fever with thrombocytopenia syndrome progression has been identified as a major risk factor associated with a poor prognosis. Here we report the case of a severely ill patient with severe fever with thrombocytopenia syndrome virus-associated encephalitis/encephalopathy characterized by a lesion of the splenium, which resolved later. CASE PRESENTATION: A 56-year-old Japanese man presented with fever and diarrhea, followed by dysarthria. Diffusion-weighted magnetic resonance imaging demonstrated high signal intensity in the splenium of the corpus callosum. The severe fever with thrombocytopenia syndrome virus genome was detected in our patient’s serum, and the clinical course was characterized by convulsion, stupor, and hemorrhagic manifestations, with disseminated intravascular coagulation and hemophagocytic lymphohistiocytosis. Supportive therapy not including administration of corticosteroids led to gradual improvement of the clinical and laboratory findings, and magnetic resonance imaging demonstrated resolution of the splenial lesion. The serum severe fever with thrombocytopenia syndrome viral copy number, which was determined with the quantitative reverse-transcription polymerase chain reaction, rapidly decreased despite the severe clinical course. Our patient’s overall condition improved, allowing him to be eventually discharged. CONCLUSIONS: Patients with encephalitis/encephalopathy due to severe fever with thrombocytopenia syndrome virus infection may have a favorable outcome, even if they exhibit splenial lesions and a severe clinical course; monitoring the serum viral load may be of value for prediction of outcome and potentially enables the avoidance of corticosteroids to intentionally cause opportunistic infection. |
format | Online Article Text |
id | pubmed-5290612 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-52906122017-02-09 Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report Kaneko, Masahiko Maruta, Masaki Shikata, Hisaharu Asou, Kengo Shinomiya, Hiroto Suzuki, Tadaki Hasegawa, Hideki Shimojima, Masayuki Saijo, Masayuki J Med Case Rep Case Report BACKGROUND: Severe fever with thrombocytopenia syndrome is an emerging infectious disease caused by a novel phlebovirus belonging to the family Bunyaviridate. Emergence of encephalitis/encephalopathy during severe fever with thrombocytopenia syndrome progression has been identified as a major risk factor associated with a poor prognosis. Here we report the case of a severely ill patient with severe fever with thrombocytopenia syndrome virus-associated encephalitis/encephalopathy characterized by a lesion of the splenium, which resolved later. CASE PRESENTATION: A 56-year-old Japanese man presented with fever and diarrhea, followed by dysarthria. Diffusion-weighted magnetic resonance imaging demonstrated high signal intensity in the splenium of the corpus callosum. The severe fever with thrombocytopenia syndrome virus genome was detected in our patient’s serum, and the clinical course was characterized by convulsion, stupor, and hemorrhagic manifestations, with disseminated intravascular coagulation and hemophagocytic lymphohistiocytosis. Supportive therapy not including administration of corticosteroids led to gradual improvement of the clinical and laboratory findings, and magnetic resonance imaging demonstrated resolution of the splenial lesion. The serum severe fever with thrombocytopenia syndrome viral copy number, which was determined with the quantitative reverse-transcription polymerase chain reaction, rapidly decreased despite the severe clinical course. Our patient’s overall condition improved, allowing him to be eventually discharged. CONCLUSIONS: Patients with encephalitis/encephalopathy due to severe fever with thrombocytopenia syndrome virus infection may have a favorable outcome, even if they exhibit splenial lesions and a severe clinical course; monitoring the serum viral load may be of value for prediction of outcome and potentially enables the avoidance of corticosteroids to intentionally cause opportunistic infection. BioMed Central 2017-02-03 /pmc/articles/PMC5290612/ /pubmed/28153057 http://dx.doi.org/10.1186/s13256-016-1192-0 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Kaneko, Masahiko Maruta, Masaki Shikata, Hisaharu Asou, Kengo Shinomiya, Hiroto Suzuki, Tadaki Hasegawa, Hideki Shimojima, Masayuki Saijo, Masayuki Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report |
title | Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report |
title_full | Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report |
title_fullStr | Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report |
title_full_unstemmed | Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report |
title_short | Unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report |
title_sort | unusual presentation of a severely ill patient having severe fever with thrombocytopenia syndrome: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290612/ https://www.ncbi.nlm.nih.gov/pubmed/28153057 http://dx.doi.org/10.1186/s13256-016-1192-0 |
work_keys_str_mv | AT kanekomasahiko unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport AT marutamasaki unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport AT shikatahisaharu unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport AT asoukengo unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport AT shinomiyahiroto unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport AT suzukitadaki unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport AT hasegawahideki unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport AT shimojimamasayuki unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport AT saijomasayuki unusualpresentationofaseverelyillpatienthavingseverefeverwiththrombocytopeniasyndromeacasereport |