Fever with thrombocytopenia syndrome
Introduction
Introduction to fever with thrombocytopenia syndrome Fever with thrombocytopenia syndrome is an acute infectious disease caused by a new type of Bunia virus. The clinical manifestations are characterized by fever and thrombocytopenia. A few patients have severe disease and develop rapidly, and can die due to multiple organ failure. . As of the end of 2011, the results of monitoring and investigation showed that most cases occurred in April-October, mostly in young and middle-aged. basic knowledge The proportion of sickness: 0.01%-0.018% Susceptible people: no specific population Mode of infection: blood transmission Complications: diffuse intravascular coagulation
Cause
Fever with thrombocytopenia syndrome
The newly discovered virus belongs to the genus Phylbovirus of the Bunyaviridae family. The virus particles are spherical, 80-100 nm in diameter, with a lipid envelope and spinous processes on the surface. The genome contains three single-stranded negative-strand RNA fragments (L, M, and S). The L-fragment is 6368 nucleotides in length and contains a single reading frame encoding RNA-dependent RNA polymerase; the M fragment has a full length of 3378 nuclei. Glycosidic acid, containing a single reading frame, encodes a 1073 amino acid glycoprotein precursor; the S fragment is an ambiguous RNA that encodes viral nucleoproteins and non-structural proteins in a bidirectional manner. The viral genome end sequence is highly conserved and, like other viral members of the genus Plasmodium, can form a pot-like structure.
The amino acid homology of the virus to the Ruku virus Uukuniemi virus of the genus Bununidae is approximately 30%. Bunia virus family virus is weak, not resistant to acid, easy to be inactivated by heat, ether, sodium deoxycholate and common disinfectants and ultraviolet radiation.
Prevention
Fever with thrombocytopenia syndrome prevention
No relevant information.
Complication
Fever with thrombocytopenia syndrome complications Complications, diffuse intravascular coagulation
Can be complicated by diffuse intravascular coagulation.
Symptom
Fever with thrombocytopenia syndrome symptoms common symptoms high fever headache muscle soreness diarrhea shock nausea and vomiting
The incubation period is not yet clear, and may range from 1 week to 2 weeks. Acute onset, the main clinical manifestations of fever, body temperature is more than 38 ° C, severe cases continue to high fever, up to 40 ° C or more, some cases of heat can be more than 10 days. With fatigue, obvious anorexia, nausea, vomiting, etc., some cases have headache, muscle aches, diarrhea and so on. Physical examination often has superficial lymph nodes such as neck and groin with tenderness, upper abdominal tenderness and relatively slow pulse.
A small number of cases are critically ill, and there are disturbances of consciousness, skin ecchymosis, gastrointestinal bleeding, pulmonary hemorrhage, etc., which can be caused by multiple organ failure such as shock, respiratory failure, and disseminated intravascular coagulation (DIC).
The vast majority of patients have a good prognosis, but the previous basic diseases, elderly patients, neuropsychiatric symptoms, bleeding tendency, hyponatremia, etc., indicate serious disease and poor prognosis.
Examine
Fever with thrombocytopenia syndrome
(1) Blood routine examination. Peripheral blood leukocyte count decreased, mostly 1.0-3.0×10/L, severe disease can be reduced to 1.0×10/L, neutrophil ratio, lymphocyte ratio is normal; platelet decrease, mostly 30-60×10 /L, severe cases can be less than 30 × 10 / L.
(2) Urine routine examination.
Proteinuria (+~+++) occurred in more than half of the cases, and urinary occult blood or hematuria occurred in a few cases.
(3) Biochemical examination.
There may be elevated levels of LDH, CK, AST, ALT, etc., especially AST, CK-MB increased, often hyponatremia, BUN increased in individual cases.
(4) Pathogen examination.
1. Serum novel Bunia virus nucleic acid detection.
2. Separation of the novel Bunia virus in serum.
Diagnosis
Diagnosis of fever with thrombocytopenia syndrome
Diagnostic criteria
According to the history of epidemiology (the season of work, life or tourism in hills, forests, mountains, etc., or the history of bites within 2 weeks before onset), clinical manifestations and laboratory test results.
1. Suspected cases: those with clinical manifestations of epidemiology, fever, and peripheral blood platelets and leukopenia.
2, confirmed cases: suspected cases have one of the following:
(1) Case specimens The new Bunia virus nucleic acid test is positive;
(2) Case specimens detected that the new Bunia virus IgG antibody positive or recovery period titer is more than 4 times higher than the acute phase;
(3) The case specimen was isolated from the novel Bunia virus.
Differential diagnosis
It should be differentiated from human granulocytic anaplasmosis such as rickettsial disease, hemorrhagic fever with renal syndrome, dengue fever, sepsis, typhoid fever, thrombocytopenic purpura and other diseases.
