Rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome-associated encephalopathy/encephalitis: a case report

Severe fever with thrombocytopenia syndrome (SFTS) is a potentially fatal infectious disease if not diagnosed and treated promptly. Typical clinical features include fever, thrombocytopenia, and lymphadenopathy. However, we encountered a case of SFTS in a 60-year-old male who initially did not exhib...

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Main Authors: Hyun Seung Kim, Seon-Jae Ahn, Han Sang Lee, Kon Chu
Format: Article
Language:English
Published: Korean Encephalitis and Neuroinflammation Society 2025-04-01
Series:Encephalitis
Subjects:
Online Access:http://encephalitisjournal.org/upload/pdf/encephalitis-2024-00108.pdf
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author Hyun Seung Kim
Seon-Jae Ahn
Han Sang Lee
Kon Chu
author_facet Hyun Seung Kim
Seon-Jae Ahn
Han Sang Lee
Kon Chu
author_sort Hyun Seung Kim
collection DOAJ
description Severe fever with thrombocytopenia syndrome (SFTS) is a potentially fatal infectious disease if not diagnosed and treated promptly. Typical clinical features include fever, thrombocytopenia, and lymphadenopathy. However, we encountered a case of SFTS in a 60-year-old male who initially did not exhibit these hallmark symptoms. The patient presented with headache and myalgia, but fever did not develop until the 4th day of hospitalization. Initial neuroimaging and cerebrospinal fluid (CSF) analysis revealed no abnormalities. When the fever emerged, follow-up imaging revealed findings consistent with meningitis as a complication of SFTS. The patient was successfully treated with antibiotics and made a full recovery. This case underscores the challenges in diagnosing SFTS in patients who lack fever, CSF pleocytosis, or typical neuroimaging findings at presentation. Additionally, it highlights the importance of differentiating SFTS-related meningitis from other causes of encephalitis to avoid inappropriate treatments, such as immunosuppressive therapy, which could worsen viral infections.
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publisher Korean Encephalitis and Neuroinflammation Society
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spelling doaj-art-505f71293aac4a56a70fef09cacb8d972025-08-20T02:11:26ZengKorean Encephalitis and Neuroinflammation SocietyEncephalitis2765-45592734-14612025-04-0152616610.47936/encephalitis.2024.0010884Rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome-associated encephalopathy/encephalitis: a case reportHyun Seung Kim0Seon-Jae Ahn1Han Sang Lee2Kon Chu3 Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaSevere fever with thrombocytopenia syndrome (SFTS) is a potentially fatal infectious disease if not diagnosed and treated promptly. Typical clinical features include fever, thrombocytopenia, and lymphadenopathy. However, we encountered a case of SFTS in a 60-year-old male who initially did not exhibit these hallmark symptoms. The patient presented with headache and myalgia, but fever did not develop until the 4th day of hospitalization. Initial neuroimaging and cerebrospinal fluid (CSF) analysis revealed no abnormalities. When the fever emerged, follow-up imaging revealed findings consistent with meningitis as a complication of SFTS. The patient was successfully treated with antibiotics and made a full recovery. This case underscores the challenges in diagnosing SFTS in patients who lack fever, CSF pleocytosis, or typical neuroimaging findings at presentation. Additionally, it highlights the importance of differentiating SFTS-related meningitis from other causes of encephalitis to avoid inappropriate treatments, such as immunosuppressive therapy, which could worsen viral infections.http://encephalitisjournal.org/upload/pdf/encephalitis-2024-00108.pdfsevere fever with thrombocytopenia syndromemeningitisseizures
spellingShingle Hyun Seung Kim
Seon-Jae Ahn
Han Sang Lee
Kon Chu
Rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome-associated encephalopathy/encephalitis: a case report
Encephalitis
severe fever with thrombocytopenia syndrome
meningitis
seizures
title Rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome-associated encephalopathy/encephalitis: a case report
title_full Rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome-associated encephalopathy/encephalitis: a case report
title_fullStr Rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome-associated encephalopathy/encephalitis: a case report
title_full_unstemmed Rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome-associated encephalopathy/encephalitis: a case report
title_short Rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome-associated encephalopathy/encephalitis: a case report
title_sort rare manifestation of initial central nervous system involvement in severe fever with thrombocytopenia syndrome associated encephalopathy encephalitis a case report
topic severe fever with thrombocytopenia syndrome
meningitis
seizures
url http://encephalitisjournal.org/upload/pdf/encephalitis-2024-00108.pdf
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