Cargando…

2308. Comparison of Clinical Characteristics Between Laboratory-Confirmed Positive and Negative Patients with Severe Fever with Thrombocytopenia Syndrome

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne emerging infectious disease caused by SFTS virus (SFTSV). Mortality of SFTS estimated to be 21.8% in South Korea, and this disease is difficult differential diagnosis. Here, we analyzed clinical characteristics between SF...

Descripción completa

Detalles Bibliográficos
Autores principales: Oh, Suhyun, Rae You, Jeong, Taek Heo, Sang, Jo, Sujin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810028/
http://dx.doi.org/10.1093/ofid/ofz360.1986
_version_ 1783462146522218496
author Oh, Suhyun
Rae You, Jeong
Taek Heo, Sang
Jo, Sujin
author_facet Oh, Suhyun
Rae You, Jeong
Taek Heo, Sang
Jo, Sujin
author_sort Oh, Suhyun
collection PubMed
description BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne emerging infectious disease caused by SFTS virus (SFTSV). Mortality of SFTS estimated to be 21.8% in South Korea, and this disease is difficult differential diagnosis. Here, we analyzed clinical characteristics between SFTS positive group (SPG) and negative group (SNG) in a primary clinical setting. METHODS: In this prospective observational study, data were collected on patients with SFTS test performed at the single teaching hospital, in South Korea, between April 2013 and December 2018. The association between each demographic, climatic, clinical, and laboratory variable was assessed. All SFTS was confirmed at the KCDC by detecting the M segment gene of SFTSV RNA using reverse transcription-polymerase chain reaction (RT–PCR), and were confirmed at our laboratory by S segment gene of SFTSV RNA using RT–PCR about patient’s family member and those with close contact. RESULTS: Of the 199 patients in the study periods, 61 (31%) were SPG and 138 (69%) were SNG. Mean age was 55.1 ± 20.3 years, and 103 (52%) patients were male. In SPG, the comorbidity score and history of tick bite were significantly higher compared with SNG. SPG and SNG were prevalent in summer and autumn, respectively (60.7% vs. 45.7%, P < 0.05). SPG was associated with mean outdoor temperature, humidity and rainfall compared with SNG (22.9°Cvs. 18.9 ℃; 78.8% vs. 70.6%; 12.6 mm vs. 8.5 mm, all P < 0.01). Dizziness, poor oral intake, nausea, and diarrhea were common in SPG. In laboratory findings, white blood cell counts, absolute neutrophil count, and C-reactive protein were significantly lower in SPG. Lymphocyte fraction, activated partial thromboplastin time, and creatinine phosphokinase were significantly higher in SPG. Case fatality of the SPG and SNG were 9.8% and 1.0%, respectively. In multivariate analysis, mean outdoor temperature, humidity, dizziness, and low CRP were predictive factors in SPG. CONCLUSION: Early prediction of SFTS diagnosis is important because this emerging zoonotic disease was a high fatality in endemic areas. When a physician wants to do SFTS test, they would consider according to this predictive variable for differentiating SFTS in primary care settings. DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-6810028
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-68100282019-10-28 2308. Comparison of Clinical Characteristics Between Laboratory-Confirmed Positive and Negative Patients with Severe Fever with Thrombocytopenia Syndrome Oh, Suhyun Rae You, Jeong Taek Heo, Sang Jo, Sujin Open Forum Infect Dis Abstracts BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne emerging infectious disease caused by SFTS virus (SFTSV). Mortality of SFTS estimated to be 21.8% in South Korea, and this disease is difficult differential diagnosis. Here, we analyzed clinical characteristics between SFTS positive group (SPG) and negative group (SNG) in a primary clinical setting. METHODS: In this prospective observational study, data were collected on patients with SFTS test performed at the single teaching hospital, in South Korea, between April 2013 and December 2018. The association between each demographic, climatic, clinical, and laboratory variable was assessed. All SFTS was confirmed at the KCDC by detecting the M segment gene of SFTSV RNA using reverse transcription-polymerase chain reaction (RT–PCR), and were confirmed at our laboratory by S segment gene of SFTSV RNA using RT–PCR about patient’s family member and those with close contact. RESULTS: Of the 199 patients in the study periods, 61 (31%) were SPG and 138 (69%) were SNG. Mean age was 55.1 ± 20.3 years, and 103 (52%) patients were male. In SPG, the comorbidity score and history of tick bite were significantly higher compared with SNG. SPG and SNG were prevalent in summer and autumn, respectively (60.7% vs. 45.7%, P < 0.05). SPG was associated with mean outdoor temperature, humidity and rainfall compared with SNG (22.9°Cvs. 18.9 ℃; 78.8% vs. 70.6%; 12.6 mm vs. 8.5 mm, all P < 0.01). Dizziness, poor oral intake, nausea, and diarrhea were common in SPG. In laboratory findings, white blood cell counts, absolute neutrophil count, and C-reactive protein were significantly lower in SPG. Lymphocyte fraction, activated partial thromboplastin time, and creatinine phosphokinase were significantly higher in SPG. Case fatality of the SPG and SNG were 9.8% and 1.0%, respectively. In multivariate analysis, mean outdoor temperature, humidity, dizziness, and low CRP were predictive factors in SPG. CONCLUSION: Early prediction of SFTS diagnosis is important because this emerging zoonotic disease was a high fatality in endemic areas. When a physician wants to do SFTS test, they would consider according to this predictive variable for differentiating SFTS in primary care settings. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810028/ http://dx.doi.org/10.1093/ofid/ofz360.1986 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Oh, Suhyun
Rae You, Jeong
Taek Heo, Sang
Jo, Sujin
2308. Comparison of Clinical Characteristics Between Laboratory-Confirmed Positive and Negative Patients with Severe Fever with Thrombocytopenia Syndrome
title 2308. Comparison of Clinical Characteristics Between Laboratory-Confirmed Positive and Negative Patients with Severe Fever with Thrombocytopenia Syndrome
title_full 2308. Comparison of Clinical Characteristics Between Laboratory-Confirmed Positive and Negative Patients with Severe Fever with Thrombocytopenia Syndrome
title_fullStr 2308. Comparison of Clinical Characteristics Between Laboratory-Confirmed Positive and Negative Patients with Severe Fever with Thrombocytopenia Syndrome
title_full_unstemmed 2308. Comparison of Clinical Characteristics Between Laboratory-Confirmed Positive and Negative Patients with Severe Fever with Thrombocytopenia Syndrome
title_short 2308. Comparison of Clinical Characteristics Between Laboratory-Confirmed Positive and Negative Patients with Severe Fever with Thrombocytopenia Syndrome
title_sort 2308. comparison of clinical characteristics between laboratory-confirmed positive and negative patients with severe fever with thrombocytopenia syndrome
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810028/
http://dx.doi.org/10.1093/ofid/ofz360.1986
work_keys_str_mv AT ohsuhyun 2308comparisonofclinicalcharacteristicsbetweenlaboratoryconfirmedpositiveandnegativepatientswithseverefeverwiththrombocytopeniasyndrome
AT raeyoujeong 2308comparisonofclinicalcharacteristicsbetweenlaboratoryconfirmedpositiveandnegativepatientswithseverefeverwiththrombocytopeniasyndrome
AT taekheosang 2308comparisonofclinicalcharacteristicsbetweenlaboratoryconfirmedpositiveandnegativepatientswithseverefeverwiththrombocytopeniasyndrome
AT josujin 2308comparisonofclinicalcharacteristicsbetweenlaboratoryconfirmedpositiveandnegativepatientswithseverefeverwiththrombocytopeniasyndrome