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Fatal Severe Fever with Thrombocytopenia Syndrome: An Autopsy Case Report

Natsumi Uehara1, Takao Yano, Akira Ishihara

  • 1Department of Internal Medicine, Miyazaki Prefectural Nobeoka Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|April 5, 2016
PubMed

Insights

Elderly patients with severe fever with thrombocytopenia syndrome (SFTS) face a lethal risk from atherosclerosis, which can cause organ damage. This condition, alongside hemophagocytic lymphohistiocytosis, contributes to mortality in older SFTS cases.

Area of Science:

  • Infectious Diseases
  • Cardiovascular Pathology
  • Geriatric Medicine

Background:

  • Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with significant mortality.
  • Elderly patients often present with complex comorbidities that can complicate disease management.

Observation:

  • An autopsy of an 83-year-old male SFTS patient revealed extensive intra-abdominal organ ischemia.
  • The ischemia was attributed to severe celiac atherosclerotic stenosis and superior mesenteric arterial thrombosis.
  • SFTS virus nucleoprotein antigen was detected in paraaortic lymph nodes, spleen, liver, bone marrow, and adrenals, with necrotizing lymphadenitis observed.

Findings:

  • Atherosclerosis, particularly severe stenosis and thrombosis of major abdominal arteries, can lead to fatal ischemic complications in SFTS patients.
  • The presence of SFTS virus in multiple organs suggests systemic viral involvement.
  • Necrotizing lymphadenitis in paraaortic nodes indicates a significant inflammatory response to the infection.

Implications:

  • Atherosclerosis should be considered a critical contributing factor to mortality in elderly SFTS patients.
  • Early recognition and management of cardiovascular risk factors may be crucial for improving outcomes in older adults with SFTS.
  • This case highlights the complex interplay between infectious disease and pre-existing chronic conditions in determining patient prognosis.
Abstract

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