Muehlenbachs Atis, Fata Cynthia R, Lambert Amy J, Paddock Christopher D, Velez Jason O, Blau Dianna M, Staples J Erin, Karlekar Mohana B, Bhatnagar Julu, Nasci Roger S, Zaki Sherif R
Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia.
Department of Pathology.
Clin Infect Dis. 2014 Sep 15;59(6):845-50. doi: 10.1093/cid/ciu434. Epub 2014 Jun 9.
Heartland virus (HRTV) is a tick-borne phlebovirus recently described in Missouri that is associated with fever, leukopenia, and thrombocytopenia. The virus has also been detected in Ambylomma americanum ticks.
Here we report the first fatal case of HRTV disease in an 80-year-old Tennessee resident. He was hospitalized with fever, confusion, leukopenia, and thrombocytopenia and developed multiorgan failure and hemorrhage. A tick-borne illness was suspected and testing for ehrlichiosis was negative. He died on hospital day 15, and autopsy specimens were tested for various pathogens as part of an unexplained death evaluation.
HRTV antigens were detected in postmortem spleen and lymph nodes by immunohistochemistry, and HRTV was detected in premortem blood by reverse transcription polymerase chain reaction and by isolation in cell culture.
This case demonstrates that HRTV infection can cause severe disease and death and expands the geographic range of HRTV within the United States.
哈特兰病毒（HRTV）是一种最近在密苏里州发现的蜱传静脉病毒，与发热、白细胞减少和血小板减少有关。该病毒也已在美洲钝缘蜱中检测到。
在此，我们报告田纳西州一名80岁居民首例因HRTV疾病死亡的病例。他因发热、意识模糊、白细胞减少和血小板减少入院，随后发展为多器官功能衰竭和出血。怀疑为蜱传疾病，埃立克体病检测呈阴性。他于住院第15天死亡，作为不明原因死亡评估的一部分，对尸检标本进行了多种病原体检测。
通过免疫组织化学在死后脾脏和淋巴结中检测到HRTV抗原，通过逆转录聚合酶链反应和细胞培养分离在生前血液中检测到HRTV。
该病例表明HRTV感染可导致严重疾病和死亡，并扩大了HRTV在美国的地理分布范围。
