BACKGROUND: The geographic spread of Japanese spotted fever (JSF) in China is gradually expanding, particularly in regions where severe fever with thrombocytopenia syndrome (SFTS) is highly prevalent, with both diseases sharing similarities in epidemiology and clinical presentation. The microbiological diagnosis of JSF is challenging, compounded by low awareness among healthcare professionals in newly affected areas. Moreover, primary healthcare facilities without polymerase chain reaction (PCR) testing capabilities for SFTS often misdiagnose JSF as SFTS.
METHODS: All 3 patients had a history of working in the fields, with cold like symptoms in the early fever stages, but the fever did not improve after a few days. The accompanying symptoms were also very different. Physical examination revealed enlarged lymph nodes, different forms of rash, with or without eschar. Laboratory tests showed thrombocytopenia, eosinophilia, elevated lactate dehydrogenase, and transaminase, with 1 patient experiencing renal damage. It is worth noting that these 3 patients reside in an area where SFTS is endemic, and there have been no prior reports of JSF. They exhibited clinical symptoms and laboratory test results closely resembling those of SFTS. Therefore, they were initially misdiagnosed with SFTS in their local hospitals.
METHODS: The 3 patients who arrived at our hospital 7 days after symptom onset and were subsequently diagnosed with JSF by metagenomic next-generation sequencing (mNGS).
METHODS: Doxycycline treatment for 1 week.
RESULTS: The patients\' symptoms quickly improved with no side effects, and the results of laboratory tests went back to normal.
CONCLUSIONS: By comparing the clinical characteristics of JSF patients and SFTS patients comprehensively, we found that APTT and procalcitonin levels may be valuable in assisting in the identification of SFTS and JSF. In all areas where tick-borne diseases are endemic, include SFTS-epidemic areas, we recommend using the Weil-Felix test to screen for potential rickettsiosis in patients presenting with fever and thrombocytopenia with or without rash in primary healthcare settings, as well as simultaneous testing for the SFTS virus and spotted fever group rickettsioses sequence. Additionally, mNGS sequencing should be used to confirm the diagnosis and provide information for epidemiological investigations in patients who are suspected of having spotted fever group rickettsiosis.

UNASSIGNED: Brucellosis and severe fever with thrombocytopenia syndrome (SFTS) are neglected zoonoses, attributable respectively to Brucella and the SFTS virus (SFTSV). While the incidence of these diseases has been rising, instances of co-infection remain uncommon.
UNASSIGNED: This represents the first documented case of a rare coinfection involving Brucella and SFTSV. We carried out an epidemiological analysis of patients diagnosed with brucellosis and those with SFTS at Yidu Central Hospital of Weifang. Our findings demonstrate a temporal and spatial overlap among the affected individuals.
UNASSIGNED: Our findings suggest that co-infections arising from the spatiotemporal overlap of Brucella and SFTSV are plausible, necessitating heightened awareness and enhanced diagnostic measures.

BACKGROUND: Severe Fever with Thrombocytopenia Syndrome (SFTS) is a tick-borne disease caused by the SFTS virus (SFTSV) which has the potential to become a pandemic and is currently a major public health concern.
METHODS: We present the case of a 74-year-old female from an urban area of Chongqing, with leukocytopenia, thrombocytopenia, organ function, inflammatory, blood coagulation, and immune abnormalities. SFTSV infection was confirmed through molecular detection and metagenomic next-generation sequencing (mNGS) analysis, indicating a diagnosis of SFTS due to the patient\'s history of tick bites. The patient received symptomatic and supportive therapy, including antibiotics, antiviral treatment, and antifungal therapy, and finally discharged from the hospital on day 18.
CONCLUSIONS: This study highlights the need for increased awareness, early diagnosis, and prompt treatment for tick-borne SFTS. It also provides a comprehensive understanding of the disease\'s characteristics, pathogenesis, detection methods, and available treatments.

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is a natural focal disease transmitted mainly by tick bites, and the causative agent is SFTS virus (SFTSV). SFTS can rapidly progress to severe disease, with multiple-organ failure (MOF) manifestations such as shock, respiratory failure, disseminated intravascular coagulation (DIC) and death, but cases of SFTS patients with central nervous system (CNS) symptoms onset and marked persistent involuntary shaking of the perioral area and limbs have rarely been reported.
METHODS: A 69-year-old woman with fever and persistent involuntary shaking of the perioral area and limbs was diagnosed with SFTS with CNS symptom onset after metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) and peripheral blood identified SFTSV. The patient developed a cytokine storm and MOF during the course of the disease, and after aggressive antiviral, glucocorticoid, and gamma globulin treatments, her clinical symptoms improved, her laboratory indices returned to normal, and she had a good prognosis.
CONCLUSIONS: This case gives us great insight that when patients with CNS symptoms similar to those of viral encephalitis combined with thrombocytopenia and leukopenia are encountered in the clinic, it is necessary to consider the possibility of SFTS involving the CNS. Testing for SFTSV nucleic acid in CSF and blood (mNGS or polymerase chain reaction (PCR)) should be carried out, especially in critically ill patients, and treatment should be given accordingly.

暂无摘要。

Severe fever with thrombocytopenia syndrome (SFTS) is a fatal infectious disease often transmitted through tick bites and exposure to fluids from infected individuals. Early diagnosis is critical due to the high mortality rates of the disease; however, it might be challenging if a patient\'s history of tick contact is unclear. We report a detailed diagnosis of SFTS in a 69-year-old man with atypical symptoms but without identifiable tick bites. The diagnosis was made on the basis of massive diarrhea, recurrent shock, and unusual erythema presentation following hospital admission.

Meningeal solitary fibrous tumors (SFTs) comprise 0.4% of primary central nervous system neoplasms and carry metastatic potential. Disease course and optimal management are largely unknown, and there is currently no literature rigorously describing neurological outcomes in surgically managed SFTs. We present one of the largest craniospinal SFT series, analyze patient outcomes, and extensively review the associated literature.
All surgically managed SFTs at our institution between January 2005 and March 2023 were retrospectively reviewed. Patient demographics, tumor and radiographic features, treatment, and clinical outcomes were collected. Neurological function was quantified using Frankel grade and Neurologic Assessment in Neuro-Oncology scores. Descriptive statistics, multivariate analysis, log-rank test, and Kaplan-Meier survival analysis were performed.
Twenty-one patients satisfied inclusion criteria. Tumor locations included 15 supratentorial, three infratentorial, and three spinal. All patients underwent surgical resection, and 16 (76.2%) underwent radiation. Six (28.6%) patients had tumor recurrence, and three (14.3%) developed metastasis. Younger age and higher postoperative Frankel grade were significantly associated with increased overall survival (OS) ( P = .011, P = .002, respectively). All patients symptomatically improved or stabilized after surgery, and Neurologic Assessment in Neuro-Oncology score ( P = .001) and functional status significantly improved postoperatively (Karnofsky Performance Status: 65.2 ± 25.2 vs 91.4 ± 13.5, P = .001). Sex, adjuvant radiation, and extent of resection were not significantly associated with OS.
SFT of the central nervous system is a rare entity with a variable clinical course. Surgical resection was associated with improved postoperative functional and neurological status. Higher postoperative neurological function was significantly associated with OS. Further studies are warranted to validate a standardized treatment algorithm and investigate the efficacy of adjuvant radiation in SFT.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS virus (SFTSV). SFTS patients were prone to invasive pulmonary aspergillosis (IPA), which was directly related to increased mortality. Here, we present a critical case of SFTS complicated by IPA in a previously healthy 58-year-old woman. On day 1, SFTSV and three different Aspergillus species were both detected in the patient\'s bronchoalveolar lavage fluid and blood through metagenomic next-generation sequencing (mNGS). After 17 days of treatment, the patient was still in poor condition and A. fumigatus was once again detected in her blood through mNGS. Then her family decided to give up treatment because of financial problems and grave prognosis. She was discharged home and died the next day. Medical personnel should be alter to the possibility of IPA in SFTS patients due to its high mortality. mNGS may be used as an auxiliary diagnostic tool and efficacy-monitoring method for suspected SFTS complicated by IPA.

BACKGROUND: A solitary fibrous tumor (SFT) is an uncommon soft tissue tumor that was first discovered in the pleura. Although SFTs have been documented in other extra-pleural sites, an SFT in the thyroid gland is highly unusual. An SFT of the thyroid gland can be difficult to diagnose, and there is little information about their Underlying biological behavior.
METHODS: We present a case of a 63-year-old man with a progressively growing left-neck mass detected 1 month ago, which was pathologically confirmed to be a benign SFT of the thyroid gland.
METHODS: Postoperative pathological examination of the tumor revealed an SFT. Immunopathological examination was consistent with the diagnosis of an SFT.
METHODS: The patient underwent surgical resection of the SFT.
RESULTS: The patient was recurrence-free during 1.5 years of follow-up.
CONCLUSIONS: Surgical excision is beneficial in SFTs that show no histological signs of malignancy, such as pleomorphism, enhanced mitotic activity, necrosis, bleeding, or capsular invasion. However, because the biologic activity remains unknown, meticulous long-term monitoring is required.

BACKGROUND: Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that typically arise from the pleura but can also occur in various locations throughout the body. Although there are increasingly more reports of extra-pleural SFTs, reports of SFTs in bone are very rare, and a malignant SFT accompanying recurrence of pelvis has not yet been reported.
METHODS: We herein present the case of a 15-year-old male who experienced intermittent numbness in his right buttock, accompanied by radiating pain in his lower limbs for 6 months. Radiological examinations revealed an expansive, heterogeneous enhanced mass in the sacral and iliac regions, with a branch of the right internal iliac artery feeding the tumor.
METHODS: The histological examination suggest a diagnosis of a malignant SFT with high proliferation activity.
METHODS: The sacral mass was surgically excised.
RESULTS: Following the surgery, the patient experienced a local recurrence of the tumor at 9 months and was administered adjuvant imatinib treatment. Recent magnetic resonance imaging contrast-enhanced displayed shrinkage of the tumor, which may provide certain evidence for chemotherapy for the treatment of recurrence of malignant SFTs in the pelvic region.
CONCLUSIONS: Complete surgical excision is the recommended treatment for this rare disease entity, and the role of adjuvant therapies is controversial due to their rarity. Our case underscores the challenges in managing recurrent malignant SFTs and highlights the importance of a thorough diagnostic workup. Further research is needed to establish the role of adjuvant therapies in the management of these tumors.