Department of Rheumatology Infectious Diseases, and Laboratory Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 8891692, Japan.
Section of Oncopathology and Regenerative Biology, Faculty of Medicine, University of Miyazaki, Miyazaki 8891692, Japan.
Viruses. 2021 Jun 7;13(6):1086. doi: 10.3390/v13061086.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne infectious disease in China, Korea, and Japan caused by the SFTS virus (SFTSV). SFTS has a high mortality rate due to multiorgan failure. Recently, there are several reports on SFTS patients with mycosis. Here, we report a middle-aged Japanese SFTS patient with invasive pulmonary aspergillosis (IPA) revealed by an autopsy. A 61-year-old man with hypertension working in forestry was bitten by a tick and developed fever, diarrhea, and anorexia in 2 days. On day 4, consciousness disorder was appearing, and the patient was transferred to the University of Miyazaki Hospital. A blood test showed leukocytopenia, thrombocytopenia, as well as elevated levels of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase. The SFTSV gene was detected in serum using a reverse-transcription polymerase chain reaction. On day 5, respiratory failure appeared and progressed rapidly, and on day 7, the patient died. An autopsy was performed that revealed hemophagocytosis in the bone marrow and bleeding of several organs. IPA was observed in lung specimens. SFTSV infection may be a risk factor for developing IPA. Early diagnosis and treatment of IPA may be important in patients with SFTS.
严重发热伴血小板减少综合征（SFTS）是一种在中国、韩国和日本流行的新型蜱传传染病，由 SFTS 病毒（SFTSV）引起。SFTS 可导致多器官衰竭，死亡率较高。最近有几例 SFTS 合并真菌感染的报告。在此，我们报告一例经尸检证实的侵袭性肺曲霉病（IPA）的中年日本 SFTS 患者。一名 61 岁的男性，有高血压病史，从事林业工作，被蜱叮咬后 2 天出现发热、腹泻和食欲不振。第 4 天出现意识障碍，患者被转至宫崎大学医院。血液检查显示白细胞减少、血小板减少以及丙氨酸转氨酶、天冬氨酸转氨酶、乳酸脱氢酶和肌酸激酶升高。采用逆转录聚合酶链反应检测血清中的 SFTSV 基因。第 5 天出现呼吸衰竭并迅速进展，第 7 天患者死亡。进行尸检发现骨髓中有噬血细胞现象和多个器官出血。肺组织标本中观察到 IPA。SFTSV 感染可能是发生 IPA 的危险因素。早期诊断和治疗 IPA 可能对 SFTS 患者很重要。
