Kubota Yoshifumi, Hiu Hiroyuki, Masuda Yukiko, Nakamichi Chikaaki
Department of Emergency and Critical Care Medicine, National Hospital Organization Nagasaki Medical Center, Nagasaki, JPN.
Cureus. 2024 Dec 9;16(12):e75408. doi: 10.7759/cureus.75408. eCollection 2024 Dec.
Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral hemorrhagic fever caused by the severe fever with thrombocytopenia syndrome virus (SFTSV). This virus, which is transmitted through ticks, is prevalent in Asian countries, including Japan. This report describes two rare cases of SFTS with concurrent bacteremia. In the first case, a 73-year-old Japanese man presented with fever and coagulopathy and subsequently developed oral mucosal hemorrhage and bloody stools. Initial tests showed thrombocytopenia and leukopenia. Blood cultures on admission revealed bacteremia, and SFTSV co-infection was subsequently confirmed by polymerase chain reaction (PCR). He was treated with vancomycin, followed by ampicillin, and recovered. In the second case, a 70-year-old Japanese man presented with fever and diarrhea and subsequently developed renal impairment and thrombocytopenia. Blood cultures on admission revealed bacteremia, and SFTSV co-infection was subsequently confirmed by PCR. He was treated with ceftriaxone, followed by ampicillin, and recovered. We conducted a literature search to look for evidence of a link between SFTS and bacteremia. Further epidemiological studies on the association between SFTS and bacteremia are warranted to provide an understanding of the pathogenic mechanisms.
严重发热伴血小板减少综合征（SFTS）是一种由严重发热伴血小板减少综合征病毒（SFTSV）引起的蜱传病毒性出血热。这种通过蜱传播的病毒在包括日本在内的亚洲国家流行。本报告描述了两例并发菌血症的罕见SFTS病例。第一例中，一名73岁的日本男性出现发热和凝血病，随后出现口腔黏膜出血和便血。初始检查显示血小板减少和白细胞减少。入院时血培养显示菌血症，随后通过聚合酶链反应（PCR）确认存在SFTSV合并感染。他接受了万古霉素治疗，随后使用氨苄西林，最终康复。第二例中，一名70岁的日本男性出现发热和腹泻，随后出现肾功能损害和血小板减少。入院时血培养显示菌血症，随后通过PCR确认存在SFTSV合并感染。他接受了头孢曲松治疗，随后使用氨苄西林，最终康复。我们进行了文献检索以寻找SFTS与菌血症之间关联的证据。有必要对SFTS与菌血症之间的关联进行进一步的流行病学研究，以了解其致病机制。
