Severe fever with thrombocytopenia syndrome complicated by invasive aspergillosis

Submitted by ROrritt on 27 March 2018

Severe fever with thrombocytopenia syndrome (SFTS) is caused by phlebovirus infection, and typically involves unexplained fever, thrombocytopenia, leukopenia, gastrointestinal symptoms and multiple organ failure. SFTS is prevalent in parts of Asia, particularly agricultural and mountainous areas.

The authors of a new paper describe the clinical features of SFTS in patients with invasive pulmonary aspergillosis (IPA). The two conditions don’t often present together, and there have been no previous reports describing their co-presentation in the scientific literature. Chen et al from Nanjing Drum Tower Hospital in China report on four cases of SFTS in IPA patients, detailing disease progression, treatment options and prognosis.

Initial presentation was characterised by symptoms of SFTS. However, after one to two weeks, patients developed mild polypnea and wheezing rales, dyspnea and respiratory failure. Tracheal intubation was ineffective. All four patients died of type 2 respiratory failure caused by airway obstruction and spasticity.

Although presentation of both conditions in a single patient is rare, the authors emphasise the need for awareness given the mortality rate in this series. They also note that early-stage treatment with antifungals and organ support may be helpful.