ABSTRACT
We report on a patient with severe fever with thrombocytopenia syndrome who fully recovered. Imaging with 2-deoxy-2-fluoro-glucose positron emission tomography showed hypermetabolism in regional lymph nodes and the spleen. Histopathological findings of affected lymph nodes showed subacute necrotizing lymphadenitis and the presence of virus-infected cells.
Subject(s)
Bunyaviridae Infections/diagnostic imaging , Bunyaviridae Infections/pathology , Fluorodeoxyglucose F18/chemistry , Lymph Nodes/pathology , Phlebotomus Fever/diagnostic imaging , Positron-Emission Tomography/methods , Biopsy , Bunyaviridae Infections/diagnosis , Bunyaviridae Infections/virology , Diagnosis, Differential , Humans , Lymph Nodes/diagnostic imaging , Lymph Nodes/virology , Male , Middle Aged , Phlebotomus Fever/diagnosis , Phlebotomus Fever/pathology , Phlebotomus Fever/virology , Phlebovirus/genetics , Phlebovirus/isolation & purification , Phlebovirus/pathogenicity , Polymerase Chain Reaction , Positron-Emission Tomography/instrumentation , Spleen/diagnostic imaging , Spleen/pathology , Spleen/virologySubject(s)
Bunyamwera virus/isolation & purification , Bunyaviridae Infections/etiology , Meningoencephalitis/etiology , Rituximab/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Atrophy , Autoimmune Diseases of the Nervous System/diagnosis , B-Lymphocytes/drug effects , B-Lymphocytes/immunology , B-Lymphocytes/pathology , Bendamustine Hydrochloride/administration & dosage , Brain/pathology , Bunyaviridae Infections/diagnosis , Bunyaviridae Infections/diagnostic imaging , Bunyaviridae Infections/virology , Diagnosis, Differential , Fatal Outcome , Gliosis/diagnostic imaging , Gliosis/etiology , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Magnetic Resonance Imaging , Maintenance Chemotherapy/adverse effects , Male , Meningoencephalitis/diagnosis , Meningoencephalitis/diagnostic imaging , Meningoencephalitis/virology , Middle Aged , Paraneoplastic Syndromes, Nervous System/diagnosis , Rituximab/administration & dosageABSTRACT
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease that causes fever, enteritis, thrombocytopenia, and leucopenia and can be fatal in up to 30% of cases. However, the mechanism of severe disease is not fully understood. Molecular imaging approaches, such as positron-emission tomography (PET), are functional in vivo imaging techniques that provide real-time dynamics of disease progression, assessments of pharmacokinetics, and diagnoses for disease progression. Molecular imaging also potentially provides useful approaches to explore the pathogenesis of viral infections. Thus, the purpose of this study was to image the pathological features of SFTSV infection in vivo by PET imaging. In a mouse model, we showed that 18F-FDG accumulations clearly identified the intestinal tract site as a pathological site. We also demonstrated that 18F-FDG PET imaging can assess disease progression and response to antiserum therapy within the same individual. This is the first report demonstrating a molecular imaging strategy for SFTSV infection. Our results provide potentially useful information for preclinical studies such as the elucidation of the mechanism of SFTSV infection in vivo and the assessment of drugs for SFTS treatment.
Subject(s)
Bunyaviridae Infections/diagnosis , Fluorodeoxyglucose F18 , Intestinal Diseases/diagnosis , Phlebovirus/growth & development , Positron-Emission Tomography/methods , Tomography, X-Ray Computed/methods , Animals , Antibodies, Viral/immunology , Antibodies, Viral/pharmacology , Bunyaviridae Infections/diagnostic imaging , Chlorocebus aethiops , Disease Models, Animal , Host-Pathogen Interactions/drug effects , Humans , Intestinal Diseases/drug therapy , Intestinal Diseases/virology , Mice , Multimodal Imaging/methods , Phlebovirus/immunology , Phlebovirus/physiology , Reproducibility of Results , Sensitivity and Specificity , Vero CellsABSTRACT
PURPOSE: To characterize chest radiographic features of Hantavirus pulmonary syndrome. MATERIALS AND METHODS: Initial and follow-up chest radiographs from 16 patients with confirmed Hantavirus pulmonary syndrome were reviewed for radiographic findings of either cardiogenic pulmonary edema or pulmonary edema due to increased permeability of the alveolar capillary membranes. RESULTS: Findings indicative of interstitial edema were present more frequently (14 [88%] of 16 patients) than is typically seen in adult respiratory distress syndrome (5%). Alveolar flooding subsequently developed in 11 (69%) of 16 patients and was not the peripheral pattern usually seen in the acute phase of adult respiratory distress syndrome. Overall mortality was 43%. Lung specimens obtained at autopsy showed a pattern of endothelial leak with minimal epithelial injury. CONCLUSION: The lung disease caused by Hantavirus in these patients may explain the findings of interstitial edema and central alveolar filling atypical of adult respiratory distress syndrome. Recognition of the radiographic pattern will be important in identifying this apparently widespread cause of increased permeability pulmonary edema.
