Acute encephalopathy associated with severe fever with thrombocytopaenia syndrome

Published on Dec 28, 2020in Case Reports
· DOI :10.1136/BCR-2020-240075
Manami Fujita (Okayama University), Yasuhiro Nakano3
Estimated H-index: 3
(Okayama University)
+ 1 AuthorsHideharu Hagiya13
Estimated H-index: 13
(Okayama University)
In July 2020, a 72-year-old Japanese woman with hypertension and dyslipidaemia presented with a 5-day history of fatigue and anorexia, followed by fever, slurred speech and involuntary movement of the upper limbs. She had not travelled abroad recently. She lived at the edge of a copse located in
#1Takeshi Hatachi (Boston Children's Hospital)H-Index: 4
#2Nobuaki Michihata (UTokyo: University of Tokyo)H-Index: 10
Last. Hideo Yasunaga (UTokyo: University of Tokyo)H-Index: 55
view all 6 authors...
Background Influenza virus-associated encephalopathy (IAE) can lead to neurological sequela and mortality among children. Therefore, instant recognition and therapeutic intervention for IAE are crucial. In some clinical subtypes of IAE, steroid pulse therapy might be beneficial, especially when it is administered in the early phase. However, early identification of patients who may benefit from steroid pulse therapy is sometimes difficult. We aimed to assess the effectiveness of early steroid pu...
2 CitationsSource
#1Shingen Nakamura (University of Tokushima)H-Index: 12
#2Momoyo Azuma (University of Tokushima)H-Index: 14
Last. Masahiro Abe (University of Tokushima)H-Index: 43
view all 15 authors...
Abstract Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease caused by the SFTS virus (SFTSV). Clinical symptoms of SFTS often involve encephalopathy and other central neurological symptoms, particularly in seriously ill patients; however, pathogenesis of encephalopathy by SFTSV is largely unknown. Herein, we present case reports of three patients with SFTS, complicated by encephalopathy, admitted to Tokushima University hospital: one patient was a 63-year-old m...
12 CitationsSource
#1Se Yoon Park (SCH: Soonchunhyang University)H-Index: 12
#2Ji-Soo Kwon (UOU: University of Ulsan)H-Index: 4
Last. Sung-Han Kim (UOU: University of Ulsan)H-Index: 58
view all 14 authors...
Abstract Objectives Severe fever with thrombocytopenia syndrome (SFTS) virus has a variety of central nervous system (CNS) manifestations. However, there are limited data regarding SFTS-associated encephalopathy/encephalitis (SFTSAE) and its mechanism. Methods All patients with confirmed SFTS who underwent cerebrospinal fluid (CSF) examination due to suspected acute encephalopathy were enrolled in three referral hospitals between January 2013 and October 2016. Real-time RT-PCR for SFTS virus and...
12 CitationsSource
#1Hirofumi Kato (Tohoku University)H-Index: 5
#2Takuya Yamagishi (NIH: National Institutes of Health)H-Index: 14
Last. Kazunori Oishi (Tohoku University)H-Index: 30
view all 7 authors...
Although severe fever with thrombocytopenia syndrome (SFTS) was first reported from Japan in 2013, the precise clinical features and the risk factors for SFTS have not been fully investigated in Japan. Ninety-six cases of severe fever with thrombocytopenia syndrome (SFTS) were notified through the national surveillance system between April 2013 and September 2014 in Japan. All cases were from western Japan, and 82 cases (85%) had an onset between April and August. A retrospective observational s...
66 CitationsSource
#1Takeshi Kawaguchi (University of Miyazaki)H-Index: 4
#2Motohiro Matsuda (University of Miyazaki)H-Index: 5
Last. Akihiko Okayama (University of Miyazaki)H-Index: 25
view all 12 authors...
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease in China, Korea and Japan caused by a novel bunyavirus, SFTS virus (SFTSV). Although central nervous system manifestations are common in SFTS patients, the pathogenesis has not been elucidated; and there are few reports of myocardial dysfunction. Here we report an elderly Japanese patient with reversible myocardial dysfunction and encephalopathy. A previously healthy 65-year-old male engaged in forestry got a ti...
10 CitationsSource
#1Zhong-Tao Gai (SDU: Shandong University)H-Index: 2
#2Ying Zhang (SDU: Shandong University)H-Index: 3
Last. Dexin Li (CCDC: Chinese Center for Disease Control and Prevention)H-Index: 36
view all 19 authors...
Background. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus (SFTSV) with an average fatality rate of 12%. The clinical factors for death in SFTS patients remain unclear. Methods. Clinical features and laboratory parameters were dynamically collected for 11 fatal and 48 non-fatal SFTS cases. Univariate logistic regression was used to evaluate the risk factors associated with death. Results. Dynamic tracking of laboratory parameters rev...
163 CitationsSource
#1En Kimura (Kumamoto University)H-Index: 22
#2Hitomi Goto (Kumamoto University)H-Index: 1
Last. Makoto Uchino (Kumamoto University)H-Index: 37
view all 7 authors...
Norovirus is an emerging pathogen that causes gastroenteritis outbreaks. Here, we reported an adult female case of norovirus-related encephalitis/encephalopathy (NvREE) with abnormal behaviour, apathy, motor aphasia, bradykinesia and gait disturbance. We treated the patient with intravenous methyl-prednisolone pulse therapy and she recovered quickly. There were slight abnormal signals in the cortex of the opercular part and insula on the MRI fluid-attenuated inversion-recovery (FLAIR) image, gen...
1 CitationsSource
#1Akihisa Okumura (Juntendo University)H-Index: 41
#2Masashi Mizuguchi (UTokyo: University of Tokyo)H-Index: 35
Last. Hirokazu Kurahashi (Fukuoka University)H-Index: 9
view all 13 authors...
Objective. To examine the relation between outcome and treatment with steroids and gammaglobulin in children with acute necrotizing encephalopathy. Methods. We retrospectively evaluated the clinical course and outcome of 34 children with acute necrotizing encephalopathy. They were divided into two groups; 17 patients with brainstem lesion and 17 patients without brainstem lesion. Early steroid use was defined as when steroids were administered within 24 h after the onset. The outcome was judged ...
126 CitationsSource
Glucocorticoids are powerful and cost-effective drugs for the treatment of patients with rheumatic disease; however, currently available glucocorticoids have several adverse effects. This Review describes the genomic and nongenomic mechanisms of glucocorticoid action; detailed knowledge of these mechanisms is crucial for researchers to develop novel glucocorticoid receptor ligands and/or to further improve the use of currently available conventional glucocorticoids.
496 CitationsSource
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