Ulcerative lesions with hemorrhage in a patient with severe fever with thrombocytopenia syndrome observed via upper gastrointestinal endoscopy

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is a novel bunyavirus infection caused by the SFTS virus (SFTSV,family Bunyaviridae,genus Phlebovirus) with a high case fatality rate. A previously healthy 72-year-old man showed symptoms of fever,general fatigue,and altered consciousness. He was hospitalized for treatment. On day 3,considering the day on which fever appeared first during the disease course as day 0,he had bloody emesis. An emergency upper gastrointestinal endoscopic examination revealed multiple ulcerative lesions with continuously oozing hemorrhage in the stomach. He died on day 7. He was retrospectively diagnosed as having SFTS,Although it was less likely that the gastric ulcerative lesions were directly induced by SFTSV replication,it was evident that hemorrhagic emesis might occur in the patient in association with the pathophysiology of SFTS. The real-time imaging of gastric ulcerative lesions in a patient with SFTS is reported.