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Two Treatment Cases of Severe Fever and Thrombocytopenia Syndrome with Oral Ribavirin and Plasma Exchange
Infection and Chemotherapy ; : 72-77, 2017.
Article in English | WPRIM | ID: wpr-81399
ABSTRACT
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease. The primary symptoms associated with SFTS are fever, thrombocytopenia, leukopenia, nausea, and vomiting. Disease progression shows high mortality rate accompanied with multiple organ failure, bleeding tendency, and altered mentality. However, only supportive care has been the basis for the treatment of SFTS. We are reporting two patients who showed central nervous system manifestation, but cured them with ribavirin together with plasma exchange in an early state. The first case is a 60-year-old male, who was admitted to the hospital with a 7-day history of fever, chills, and thrombocytopenia. He was treated with empirical antibiotics; however, he experienced persistent high fever and an altered mentality has occurred. On hospital day 6, the SFTS virus (SFTSV) result from a real-time reverse transcription-polymerase chain reaction (RT-PCR) was confirmed positive. Therefore, ribavirin (30 mg/kg as initial loading dose, 15 mg/kg qid for 4 days and then 7.5 mg/kg qid as maintenance dose) was administered orally for 11 days and plasma exchange was performed for 5 days. The clinical outcome has improved. The second case is a 48-year-old male, who was admitted to the hospital with a 10-day history of fever, chills, myalgia, diarrhea, and thrombocytopenia. He was treated with empirical antibiotics. On hospital day 3, ribavirin (30 mg/kg as initial loading dose, 15 mg/kg qid as maintenance dose) was administered orally for 4 days and plasma exchange was performed for 4 days due to his high fever and altered mentality after a positive SFTSV result from a real-time RT-PCR. The patient had a successful recovery.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Plasma / Plasma Exchange / Ribavirin / Thrombocytopenia / Vomiting / Central Nervous System / Mortality / Orthobunyavirus / Tick-Borne Diseases / Disease Progression Type of study: Prognostic study Limits: Humans / Male Language: English Journal: Infection and Chemotherapy Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Plasma / Plasma Exchange / Ribavirin / Thrombocytopenia / Vomiting / Central Nervous System / Mortality / Orthobunyavirus / Tick-Borne Diseases / Disease Progression Type of study: Prognostic study Limits: Humans / Male Language: English Journal: Infection and Chemotherapy Year: 2017 Type: Article