http://www.nejm.org/doi/full/10.1056/NEJMoa1010095
Clinical Symptoms
The first patient, a 42-year-old male farmer, presented with fever (temperatures of 39.2 to 39.7C), fatigue, conjunctival congestion, diarrhea, abdominal pain, leukocytopenia, thrombocytopenia, proteinuria, and hematuria. Later, a unique group of hospitalized patients with acute high fever with thrombocytopenia was identified. We analyzed only 81 patients with laboratory-confirmed SFTSV infection who had a complete medical record for the clinical spectrum of SFTS. The clinical symptoms of SFTS were nonspecific, and the major symptoms included fever and gastrointestinal symptoms. Regional lymphadenopathy was also frequently observed (Table 2Table 2
Clinical Symptoms of Hospitalized Patients with Laboratory-Confirmed SFTS.). The most common abnormalities on laboratory testing were thrombocytopenia (95%) and leukocytopenia (86%) (Table 3Table 3
Laboratory Findings in Patients with SFTS.). Multiorgan failure developed rapidly in most patients, as shown by elevated levels of serum alanine aminotransferase, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase. Proteinuria (in 84% of patients) and hematuria (in 59%) were also observed. Among the 171 confirmed cases, there were 21 deaths (12%). However, it is not clear how SFTSV caused these deaths.