title: Retrospective survey of severe fever with thrombocytopenia syndrome in patients with suspected rickettsiosis in Japan.
abstract: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus (SFTSV). The aim of this study was to clarify whether SFTS is potentially mis-diagnosed as rickettsioses, including spotted fever, typhus fever, and scrub typhus, which are also tick-borne disease. A total of 464 serum samples collected from 222 patients with clinically suspected rickettsiosis between 1999 and 2012 were tested for antibodies against the SFTSV. Of the 464 serum samples, one was positive for antibodies against the virus in an enzyme-linked immunosorbent assay and indirect immunofluorescence assay. The patient of SFTSV antibody-positive sample (15 days after disease onset) was positive for SFTSV genome in the acute phase sample (3 days after disease onset) as determined via reverse transcription-quantitative polymerase chain reaction. This patient, who was a resident of the Yamaguchi prefecture in Western Japan, was in his 40s when he showed symptoms in 2011. As the result, 1 of 222 patients, who was clinically suspected of rickettsiosis, was retrospectively diagnosed with SFTS. In this case, both the C-reactive protein and white blood cell count levels were lower than the ranges of these parameters for patients diagnosed with rickettsiosis. Therefore, SFTS should be considered in the differential diagnosis for rickettsiosis in Japan.
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Satoh
authors.affiliation: Tokuyama Central Hospital, 1-1 Kodacho, Shunan-City, Yamaguchi, 745-8522, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Akashi
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Tokuyama Central Hospital, 1-1 Kodacho, Shunan-City, Yamaguchi, 745-8522, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Wakeyama
authors.affiliation: Tokuyama Central Hospital, 1-1 Kodacho, Shunan-City, Yamaguchi, 745-8522, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Fukuma
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Taniguchi
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Tani
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurosu
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Shuetsu
authors.initials: S
authors.lastname: Fukushi
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shimojima
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Ando
authors.affiliation: Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan. Electronic address: msaijo@niid.go.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Saijo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count / Q000379:methods; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D008297:Male; D008875:Middle Aged; D016856:Phlebovirus; D012189:Retrospective Studies; D012282:Rickettsia Infections / Q000175:diagnosis / Q000378:metabolism / Q000821:virology; D011795:Surveys and Questionnaires; D013921:Thrombocytopenia / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology*; D017282:Tick-Borne Diseases / Q000175:diagnosis / Q000378:metabolism / Q000821:virology; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
keywords: Japanese spotted fever; Rickettsiosis; Severe fever with thrombocytopenia syndrome; Tick-borne infectious diseases