Case Report: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone
BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus with a high mortality rate. Cytokine storm could be regarded as an important feature of SFTS patients. Severe or critical cases of SFTS are often complicated with the presence...
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Frontiers Media S.A.
2025-06-01
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| author | Liang Qiao Liang Qiao Liang Qiao Liang Qiao Ting-juan Zhang Ting-juan Zhang Ting-juan Zhang Ting-juan Zhang Yuan Feng Yuan Feng Yuan Feng Yuan Feng Lei Yang Lei Yang Lei Yang Lei Yang Ping Cai Ping Cai Ping Cai Ping Cai Su-wan Liu Yong-hui Ji Yong-hui Ji Yong-hui Ji Yong-hui Ji Jun Qian Jun Qian Jun Qian Jun Qian Jing-dong Zhou Jing-dong Zhou Jing-dong Zhou Jing-dong Zhou |
| author_facet | Liang Qiao Liang Qiao Liang Qiao Liang Qiao Ting-juan Zhang Ting-juan Zhang Ting-juan Zhang Ting-juan Zhang Yuan Feng Yuan Feng Yuan Feng Yuan Feng Lei Yang Lei Yang Lei Yang Lei Yang Ping Cai Ping Cai Ping Cai Ping Cai Su-wan Liu Yong-hui Ji Yong-hui Ji Yong-hui Ji Yong-hui Ji Jun Qian Jun Qian Jun Qian Jun Qian Jing-dong Zhou Jing-dong Zhou Jing-dong Zhou Jing-dong Zhou |
| author_sort | Liang Qiao |
| collection | DOAJ |
| description | BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus with a high mortality rate. Cytokine storm could be regarded as an important feature of SFTS patients. Severe or critical cases of SFTS are often complicated with the presence of hemophagocytic lymphohistiocytosis (HLH), resulted in rapid disease progression and extremely adverse prognosis. Currently, effective treatments for these severe cases remain unavailable. Herein, we reported a case of SFTS associated with HLH successfully treated by favipiravir and methylprednisolone.Case presentationA 73-year-old male farmer was admitted to our hospital with a fever, fatigue, and bicytopenia for 1 week on June 20, 2024. The patient had a history of farm work. The diagnosis of SFTS was confirmed by detection of Bunyavirus RNA in the blood samples. Bone marrow examination revealed marked infiltration of macrophages with hemophagocytosis in the bone marrow leading to a diagnosis of HLH. Notably, the patient was preemptively treated with favipiravir together with methylprednisolone and supportive therapy before the diagnosis of SFTS associated with HLH. Excitingly, the patient was recovered after 10 days treatment.ConclusionEarly recognition of SFTS complicated with HLH is particularly important, and the preemptive application of favipiravir may improve the prognosis of these patients. |
| format | Article |
| id | doaj-art-939e7371ff0f4ce7860e1caed0fa45a2 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-939e7371ff0f4ce7860e1caed0fa45a22025-08-20T03:25:42ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15667191566719Case Report: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisoloneLiang Qiao0Liang Qiao1Liang Qiao2Liang Qiao3Ting-juan Zhang4Ting-juan Zhang5Ting-juan Zhang6Ting-juan Zhang7Yuan Feng8Yuan Feng9Yuan Feng10Yuan Feng11Lei Yang12Lei Yang13Lei Yang14Lei Yang15Ping Cai16Ping Cai17Ping Cai18Ping Cai19Su-wan Liu20Yong-hui Ji21Yong-hui Ji22Yong-hui Ji23Yong-hui Ji24Jun Qian25Jun Qian26Jun Qian27Jun Qian28Jing-dong Zhou29Jing-dong Zhou30Jing-dong Zhou31Jing-dong Zhou32Department of Hematology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaInstitute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, ChinaZhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, ChinaThe Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, ChinaDepartment of Hematology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaInstitute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, ChinaZhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, ChinaThe Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, ChinaDepartment of Hematology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaInstitute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, ChinaZhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, ChinaThe Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, ChinaDepartment of Hematology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaInstitute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, ChinaZhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, ChinaThe Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, ChinaDepartment of Hematology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaInstitute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, ChinaZhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, ChinaThe Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, ChinaLaboratory Center, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaDepartment of Hematology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaInstitute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, ChinaZhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, ChinaThe Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, ChinaDepartment of Hematology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaInstitute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, ChinaZhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, ChinaThe Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, ChinaDepartment of Hematology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, ChinaInstitute of Hematology, Jiangsu University, Zhenjiang, Jiangsu, ChinaZhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, ChinaThe Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, ChinaBackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus with a high mortality rate. Cytokine storm could be regarded as an important feature of SFTS patients. Severe or critical cases of SFTS are often complicated with the presence of hemophagocytic lymphohistiocytosis (HLH), resulted in rapid disease progression and extremely adverse prognosis. Currently, effective treatments for these severe cases remain unavailable. Herein, we reported a case of SFTS associated with HLH successfully treated by favipiravir and methylprednisolone.Case presentationA 73-year-old male farmer was admitted to our hospital with a fever, fatigue, and bicytopenia for 1 week on June 20, 2024. The patient had a history of farm work. The diagnosis of SFTS was confirmed by detection of Bunyavirus RNA in the blood samples. Bone marrow examination revealed marked infiltration of macrophages with hemophagocytosis in the bone marrow leading to a diagnosis of HLH. Notably, the patient was preemptively treated with favipiravir together with methylprednisolone and supportive therapy before the diagnosis of SFTS associated with HLH. Excitingly, the patient was recovered after 10 days treatment.ConclusionEarly recognition of SFTS complicated with HLH is particularly important, and the preemptive application of favipiravir may improve the prognosis of these patients.https://www.frontiersin.org/articles/10.3389/fmed.2025.1566719/fullsevere fever with thrombocytopenia syndromehemophagocytic lymphohistiocytosispreemptive treatmentfavipiravircase report |
| spellingShingle | Liang Qiao Liang Qiao Liang Qiao Liang Qiao Ting-juan Zhang Ting-juan Zhang Ting-juan Zhang Ting-juan Zhang Yuan Feng Yuan Feng Yuan Feng Yuan Feng Lei Yang Lei Yang Lei Yang Lei Yang Ping Cai Ping Cai Ping Cai Ping Cai Su-wan Liu Yong-hui Ji Yong-hui Ji Yong-hui Ji Yong-hui Ji Jun Qian Jun Qian Jun Qian Jun Qian Jing-dong Zhou Jing-dong Zhou Jing-dong Zhou Jing-dong Zhou Case Report: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone Frontiers in Medicine severe fever with thrombocytopenia syndrome hemophagocytic lymphohistiocytosis preemptive treatment favipiravir case report |
| title | Case Report: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone |
| title_full | Case Report: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone |
| title_fullStr | Case Report: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone |
| title_full_unstemmed | Case Report: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone |
| title_short | Case Report: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone |
| title_sort | case report successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone |
| topic | severe fever with thrombocytopenia syndrome hemophagocytic lymphohistiocytosis preemptive treatment favipiravir case report |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1566719/full |
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