Severe fever with thrombocytopenia syndrome with myocardial dysfunction and encephalopathy: A case report

Kawaguchi, Takeshi; Matsuda, Monique; Takajo, Ichiro; Kawano, Ayako; Kariya, Yumi; Kubo, Kazuyoshi; Miyauchi, Syunichi; Nagatomo, Yasuhiro; Yano, Takao; Yano, Kouji; Okayama, Akira

doi:10.1016/j.jiac.2016.01.022

Cited by 18 publications

(14 citation statements)

References 11 publications

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“…This suggested that SFTSV can directly infect the heart. Although severe SFTS cases could suffer myocardial dysfunction [13, 21], diffuse ST elevation in electrocardiogram or narrowing of LV cavity and diffuse LV wall thickness in echocardiogram were not evident in these cases, and thus these cases were not suspected of having myocarditis.…”

Section: Discussionmentioning

confidence: 99%

Fulminant myocarditis associated with severe fever with thrombocytopenia syndrome: a case report

et al. 2019

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BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging viral infectious disease with high mortality. It causes multiple organ dysfunction; however, myocarditis has never been reported as a complication with SFTS.Case presentationA 62-year-old previously healthy woman developed fever, fatigue, diarrhea, and a mild consciousness disorder. She visited a local clinic, and laboratory data showed leukocytopenia, thrombocytopenia, and elevation of the aspartate aminotransferase level. She was transferred to Kagoshima University Hospital and diagnosed as having SFTS by real-time reverse transcription polymerase chain reaction. Subsequently, her blood pressure gradually decreased despite fluid resuscitation and vasopressor administration. Based on elevated toroponin I levels in serum, a transient diffuse left ventricular hypokinesis and wall thickening in echocardiography, diffuse ST elevation in electrocardiography, and exclusion of other heart diseases, she was diagnosed as having fulminant myocarditis. After hemodynamic support with inotropic agents, she recovered near normal cardiac function. She was discharged to home on day 28.ConclusionsWe report the first case of fulminant myocarditis associated with SFTS.

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Section: Discussionmentioning

confidence: 99%

Fulminant myocarditis associated with severe fever with thrombocytopenia syndrome: a case report

et al. 2019

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“…Supportive therapies for patients with SFTS include blood transfusion, renal replacement therapy, plasma exchange, and antibiotics. Several case reports have shown that corticosteroid (CS) administration was effective for patients with SFTS and hemophagocytic syndrome (HPS) [ 13 ]. However, a retrospective study conducted in South Korea found that the CS-treated group had a higher mortality rate than the non-CS-treated group [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study

Kawaguchi

Yamanaka

Hara

et al. 2021

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Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. To date, no standardized treatment protocol for SFTS has been established. Corticosteroids (CS) may be administered to patients with SFTS and hemophagocytic syndrome, but its effectiveness and safety are still debatable. We conducted a retrospective case series review at four medical facilities in Miyazaki, Japan. Based on the medical records, clinical data, including the patients background, symptoms, physical findings, laboratory data at initial presentation, treatment, and outcome, were compared between the CS-treated and the non-CS-treated group. A total of 47 patients with confirmed SFTS in each hospital were enrolled in this study; there were 14 fatal cases and 33 nonfatal cases. The case fatality ratio was 29.8%. After adjusting patients’ background by propensity score matching, the case fatality ratio was higher (p = 0.04) and complications of secondary infections, including invasive pulmonary aspergillosis, tended to be more frequent (p = 0.07) in the CS-treated group than in the non-CS-treated group. These data suggested that administration of CS to patients with SFTS should be carefully considered.

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“…Although glucocorticoid may be commonly administered for virus-associated encephalopathy with the expectation of inhibiting cytokine production and function,6 its effectiveness is yet to be established; some literatures reporting effectiveness of the steroid therapy in acute encephalopathy7 8 and others not 9. While it has been reported that patients treated with glucocorticoid recovered without neurological sequelae,3 4 the neurological impairment remained in the present case. Since neurological complications are poor prognostic factors for the quality of the remainder of the patient’s life, the neurological findings should be noted in patients with SFTS.…”

Section: Descriptionmentioning

confidence: 65%

“…Neurological complications are relatively common (71%) in Japanese patients with SFTS,1 the symptoms of which include disorientation, muscle weakness, tremor, dysarthria and seizures lasting between 5 days and 2 weeks 2. Imaging studies using CT and MRI usually show no abnormalities in the head, while mild abnormalities in protein, glucose and cell count can be observed during cerebrospinal fluid examination 3 4. Elevated levels of cytokines, such as interleukin-8 and monocyte chemoattractant protein-1, have been reported in the spinal fluid of patients, suggesting that SFTSV-associated cytokine storm may contribute to the development of encephalopathy 5.…”

Section: Descriptionmentioning

confidence: 99%

Acute encephalopathy associated with severe fever with thrombocytopaenia syndrome

et al. 2020

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Severe fever with thrombocytopenia syndrome with myocardial dysfunction and encephalopathy: A case report

Cited by 18 publications

References 11 publications

Fulminant myocarditis associated with severe fever with thrombocytopenia syndrome: a case report

Fulminant myocarditis associated with severe fever with thrombocytopenia syndrome: a case report

Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study

Acute encephalopathy associated with severe fever with thrombocytopaenia syndrome

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