Patient with severe fever with thrombocytopenia syndrome virus infection and central nervous system disturbance in Dongyang, Zhejiang Province, China, 2017.

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever that was first described in China in 2011. We report a patient who died of Severe fever with thrombocytopenia syndrome virus (SFTSV) infection, with a rapidly progressive central nervous system (CNS) disturbance, in Dongyang, Zhejiang Province, China, in 2017. CASE PRESENTATION: A 64-year-old man was admitted to hospital after 4 days of fever. SFTSV was detected 1 day after the patient was admitted to hospital. The patient presented with CNS disturbance and died 4 days after admission. Detailed clinical and epidemiological investigations and laboratory tests were conducted. Reduced platelet, white blood cell, lymphocyte, and neutrophil counts, elevated lactate dehydrogenase, creatine kinase, aspartate aminotransferaseand alanine aminotransferase concentrations, and an increased activated partial thromboplastin time were observed. In a phylogenetic analysis, the isolate clustered close to a strain derived from South Korea. CONCLUSIONS: This is the first case of SFTSV infection with CNS disturbance in Dongyang, Zhejiang Province, China. The surveillance of suspected cases of SFTS is important in SFTSV endemic regions.

[CT imaging characteristics of incomplete and complete myocardial bridges-mural coronary artery].

OBJECTIVE: To evaluate the CT imaging characteristics of incomplete and complete myocardial bridges-mural coronary artery (MB-MCA). METHODS: Fifty subjects with dual source coronary CT angiography (DSCTA) evidenced MB were included. The subjects were divided into incomplete MB-MCA and complete MB-MCA groups. The diameter of MCA in best systole phase and diastole phase, the MCA stenosis rate, the presence of atheromatous change proximal to the MB were evaluated. RESULTS: There were 58 MB, the average length was (2.02 ± 1.02) cm, 23 were incomplete MB and 35 were complete MB. Thirty-two MB were in the middle segments of left anterior descending artery (55.2%); 17 MB were in the distal segment of the left anterior descending artery (29.3%); 1 MB was in the proximal segment of left anterior descending artery; 3 MB in diagonal branch; 4 MB in obtuse marginal branch, 1 MB in distal right coronary artery. It was statistically significant difference between the incomplete MB-MCA and the complete MB-MCA of the diameter change in diastole and systole phase [(1.93 ± 0.49) mm, (1.71 ± 0.45) mm vs. (2.21 ± 0.41) mm, (1.63 ± 0.52) mm, P = 0.008] and stenosis rate (10.38% ± 20.2% vs. 25.12% ± 21.02%, P = 0.01). Atherosclerotic finding was evidenced in 8 incomplete MB (34.78%) and 15 complete MB (42.86%) at the proximal vessel of mural coronary artery (P > 0.05). CONCLUSION: DSCTA can vividly display the incomplete and complete myocardial MB, accurately evaluate the shape change of MB-MCA in diastole and systole phase and detect the atherosclerotic change in the proximal vessel of MB.