Multiple organ involvement in severe fever with thrombocytopenia syndrome: an immunohistochemical finding in a fatal case

Abstract

AbstractsBackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS bunyavirus (SFTSV), a tick borne bunyavirus. However, Immunohistochemistry of SFTS patients are not well studied.MethodsWe obtained multiple of tissues from a fatal case with SFTS, including blood, lungs, kidneys, heart, and spleen. The blood samples were used to isolate the causative agent for detection of viral RNA and further expression of recombinant viral protein as primary antibody. Immunohistochemistry of the heart, lungs, spleen and kidneys was used to characterize the viral antigen in tissue sections.ResultsA 79-year-old man, together with his wife, was admitted because of fever. Both patients were diagnosed with SFTS by the positive SFTSV RNA in the blood. The gentleman died of multiple organ failure 8 days after hospitalization. However, his wife recovered and was discharged. Immunohistochemistry indicated that SFTSV antigens were present in all studied organs including the heart, kidney, lung and spleen, of which the spleen presented with the highest amount of SFTSV antigens. The kidney was next while the heart and lungs showed lower amount of SFTSV antigens.ConclusionsSFTSV can direct infect multiple organs, resulting in multiple organ failure and ultimately in an unfavorable outcome.Electronic supplementary materialThe online version of this article (10.1186/s12985-018-1006-7) contains supplementary material, which is available to authorized users.

Severe fever with thrombocytopenia syndrome virus targets B cells in lethal human infections

“…Systemic dissemination of SFTSV-infected B cells in fatal SFTS. SFTSV-infected cells have been detected in multiple nonlymphoid organs, such as the liver, adrenal glands, intestine, heart, lungs, and kidneys in most examinations of fatal human SFTS (18,34,37). Here, we analyzed, by IHC, the distribution of SFTSVinfected cells in nonlymphoid organs obtained postmortem from 22 individuals with fatal SFTS.…”

“…In addition, elucidation of the cell and tissue tropism associated with mortality can explain viral lethality (33). Results from histopathological studies have shown that necrotizing lymphadenitis and prominent hemophagocytosis are the pathological characteristics of fatal SFTS, and large atypical immunoblastic cells are major infected cells in the lymph nodes, spleen, and bone marrow (6,18,(34)(35)(36)(37). However, detailed characterization of the viral target cells and tissues is required to understand the pathogenic mechanisms of lethal SFTSV infection.…”

Epidemiological Characteristics and Clinical Features of Patients With Severe Fever With Thrombocytopenia Syndrome Bunyavirus Infection

“…All of the above suggests that SFTSV can involve the patients'multiple organs. Some studies have shown that the spleen contains the highest density of SFTSV [15].…”

Reactive plasmacytosis mimicking multiple myeloma associated with SFTS virus infection: a report of two cases and literature review

“…Hematuria and fecal occult blood were also observed (Table 3 ). Taken together, these findings indicated that SFTSV is a pantropic virus that injures most tissues and cells; it can invade the hematological system, cardiac muscles, the liver, kidneys, and the coagulation system, inducing related symptoms and abnormal examination results [ 7 , 13 – 15 ]. Therefore, early diagnosis and treatment is beneficial for patient survival.…”