A Disease that Should be Remembered in Children: Sandfly Fever in a Child with Fever and Bicytopenia

Abstract

Although the common clinical findings of viral infections are fever and various skin rashes (maculopapular, vesicular petechial etc.), they may cause alterations in peripheric blood cell counts such as bicytopenia, pancytopenia. Especialy in recent years, Crimean-Congo hemorrhagic fever (CCHF) has started to be considered primarily in patients with complaints of fever, petechia and bicytopenia in Turkey. However, some rare viral agents may also cause the same findings. In this case, we reported a patient with sandfly fever, initially misdiagnosed as CCHF because of the clinical and laboratory findings mentioned above.

Novel and emergent sandfly‐borne phleboviruses in Asia Minor: a systematic review

“…25 In addition to the confirmed cases, the diagnosis of febrile disease due to phlebovirus infections has been considered in some cases and case clusters, mostly with epidemiological risks and/or a history of sandfly exposure, in adult and pediatric cases originating from Central and Mediterranean Anatolia. 17,19,22,24,25,28,32,34 The clinical presentation and routine laboratory evaluations in these cohorts were frequently consistent with typical phlebovirus infections. 2 The specific diagnostic assays universally involved the detection of group or With the exception of TOSV, no evidence of phlebovirus infections, supported by virus isolation and/or viral nucleic acid detection, has been obtained in animals.…”

“…In addition to the confirmed cases, the diagnosis of febrile disease due to phlebovirus infections has been considered in some cases and case clusters, mostly with epidemiological risks and/or a history of sandfly exposure, in adult and pediatric cases originating from Central and Mediterranean Anatolia . The clinical presentation and routine laboratory evaluations in these cohorts were frequently consistent with typical phlebovirus infections .…”

“…Thirty-one manuscripts published reports on phleboviruses from Anatolia/Asia Minor. These manuscripts provided data on phlebovirus-associated case reports and/or outbreak investigations (n: 19), [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] human exposure based on serosurveillance (n: 7), 20,29,[35][36][37][38][39] animal infections and exposure (n: 2), 40,41 virus characterization (n: 4), 18,40,42,43 vector surveillance (n: 6), 31,37,40,42,44,45 and diagnostics (n: 1), 46 some comprising more than 1 aspect (Table 1).…”

“…A total of 1693 database entries that comprise 1491 (88.1%) international and 202 (11.9%) regional reports were accessed. Following the omission of repetitive and/or unrelated records, 42 manuscripts emerged . A detailed assessment of content in this cohort revealed that 2 reports were merely focusing on West Nile virus without presenting data on phleboviruses and were subsequently omitted .…”

Overview of West Nile Virus and Sandfly-borne Phlebovirus Infections in Anatolia

“…Sandfly fever was suggested in a 14 yearold male patient with fever and bicytopenia but information on diagnostic assay or the virus serotype were not available. 53 Although very few sporadic cases of SFSV-like isolates involved in encephalitis or meningoencephalitis have been recognized, a case of central nervous system infection due to SFTV was reported, indicating that the strain might be neuroinvasive as well. 54 The patient was a 63-year-old female from Diyarbakir province (southeastern Anatolia) with high fever, alteration of consciousness, elevated liver enzymes, blood urea nitrogen and creatinine.…”