The Diagnosis of Severe Fever with Thrombocytopenia Syndrome Using Metagenomic Next-Generation Sequencing: Case Report and Literature Review

Abstract

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an infectious disease caused by a bunyaviridae virus. Its main clinical manifestation is fever with thrombocytopenia, which may be accompanied by other clinical symptoms. Here, we report a patient diagnosed with SFTS using metagenomic next-generation sequencing (mNGS). Case Presentation: A 56-year-old female patient was hospitalized with intermittent diarrhea and fever. She visited a local clinic for treatment, but instead of improving, the symptoms progressed to unconsciousness. Diagnosis: Using mNGS, we isolated the bunyaviridae virus and several other pathogens from the patient's blood samples to confirm the diagnosis. Interventions:The patient was treated with symptomatic and supportive therapy, including intravenous human γ-globulin (20 g/d), platelet transfusion, platelet elevation (subcutaneous injection of recombinant human thrombopoietin, 15,000 IU), white blood cell elevation (subcutaneous injection of recombinant human granulocyte colony-stimulating factor, 200 ug, qd); and antibiotic (cefoperazone sodium and tazobactam sodium, 2 g, q8h), antiviral (ganciclovir, 250 mg, q12h), and antifungal therapy (voriconazole for injection, 0.2 g, q12h). After ten days of treatment, the patient's condition gradually improved. Conclusion: Compared to traditional detection methods, mNGS has many advantages. It can quickly identify the pathogen when the patient's clinical manifestations are complex and difficult to diagnose, resulting in the formulation of an effective treatment.

Diagnostic value of metagenomic next-generation sequencing in sepsis and bloodstream infection

“…Our study contains similar findings, suggesting that mNGS has limited utility in fungal BSI. Blood cultures failed to detect viruses, unlike mNGS, which not only detected viruses but also detected rare pathogens (Leishmania donovani species complex, Bacillus cereus population) and was therefore more suitable to detect unknown infections, a finding which is consistent with previous studies (Duan et al, 2021;Geng et al, 2021;Govender et al, 2021;Zhan et al, 2022).…”

Clinical Application and Influencing Factor Analysis of Metagenomic Next-Generation Sequencing (mNGS) in ICU Patients With Sepsis

“…This is consistent with the views of Zheng et al (Zheng et al, 2022). Highlighting the clinical advantages of NGS in finding particular fastidious pathogenic bacteria that can guide the clinical treatment better (Kruppa et al, 2018;Duan et al, 2021b;Govender et al, 2021;Tsang et al, 2021;Zhan et al, 2022). This study showed that the mNGS positive rate was higher, and the mNGS pathogen coverage accounted for 54.17% (13/24) of the total number of positive blood culture results, and two other patients showed positive results only in blood cultures.…”

“…( Zheng et al., 2022 ). Highlighting the clinical advantages of NGS in finding particular fastidious pathogenic bacteria that can guide the clinical treatment better ( Kruppa et al., 2018 ; Duan et al., 2021b ; Govender et al., 2021 ; Tsang et al., 2021 ; Zhan et al., 2022 ).…”

Immune Thrombocytopenia Relapse in Patients Who Received mRNA COVID-19 Vaccines [Letter]

“…Some infections like dengue, malaria, and severe fever with thrombocytopenia syndrome (SFTs) 4 may have resulted in thrombocytopenia. Was any investigation done to rule it out?…”