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新发传染病电子杂志 ›› 2025, Vol. 10 ›› Issue (2): 75-80.doi: 10.19871/j.cnki.xfcrbzz.2025.02.013

• 病例报道 • 上一篇    下一篇

深圳市1例输入性C基因型重型发热伴血小板减少综合征病例的临床与分子特征分析

陈霓璇1#, 吴延杰2#, 万佳1, 陈毅华2, 孔东锋1, 张振1, 石晓路3, 吕子全4, 阳帆3, 吴春利3, 王夕冉4, 叶郁辉2   

  1. 1.深圳市疾病预防控制中心传染病防控科, 广东 深圳 518055;
    2.北京大学深圳医院预防保健与医院感染管理部, 广东 深圳 518036;
    3.深圳市疾病预防控制中心病原微生物检验所, 广东 深圳 518055;
    4.深圳市疾病预防控制中心生物资源保藏与应用部, 广东 深圳 518055
  • 收稿日期:2024-09-12 发布日期:2025-06-16
  • 通讯作者: 孔东锋,Email:eastwind1234@21cn.com。
  • 作者简介:#,共同第一作者
  • 基金资助:
    1.深圳市科技计划项目(RKX20200327095612234); 2.深圳市医学重点学科项目(SZXK064)

An imported case of genotype c severe fever with thrombocytopenia syndrome in shenzhen: clinical and molecular characteristics insights

Chen Nixuan1, Wu Yanjie2, Wan Jia1, Chen Yihua2, Kong Dongfeng1, Zhang Zhen1, Shi Xiaolu3, Lyu Ziquan4, Yang Fan3, Wu Chunli3, Wang Xiran4, Ye Yuhui2   

  1. 1. Department of Infectious Disease Prevention and Control, Shenzhen Center for Disease Control and Prevention, Guangdong Shenzhen 518055, China;
    2. Prevention & Health Care and Hospital Infection Control Department, Peking University Shenzhen Hospital, Guangdong Shenzhen 518036, China;
    3. Pathogen Microbiology Laboratory, Shenzhen Center for Disease Control and Prevention, Guangdong Shenzhen 518055, China;
    4. Department of Biological Resources Conservation and Utilization, Shenzhen Center for Disease Control and Prevention, Guangdong Shenzhen 518055, China
  • Received:2024-09-12 Published:2025-06-16

摘要: 发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)是由发热伴血小板减少综合征病毒(severe fever with thrombocytopenia syndrome virus, SFTSV)引起的急性自然疫源性传染病,以发热、胃肠道症状、血小板及白细胞减少为主要临床表现。本文报道1例由安徽省输入深圳市的C基因型重型SFTS病例。患者为老年男性,发病前常住安徽省安庆市太湖县农村(当地为SFTS自然疫源地且蜱媒监测密度较高),发病前两周有频繁田间劳作史,推测因蜱虫叮咬感染。患者急性起病,临床表现为持续发热、白细胞减少、进行性血小板减少(最低26×109/L)及多器官功能损伤(肝酶、心肌酶显著升高),确诊为重型SFTS病例。实验室检测显示血液及咽拭子SFTSV核酸阳性(Ct值分别为27、33),血清SFTSV IgM抗体阳性、IgG抗体阴性。全基因组测序结果表明该病例感染毒株属于C基因型,与湖北省分离株亲缘关系较近。经输注血小板、免疫球蛋白及白蛋白等对症支持治疗13d后好转出院。本研究通过系统回顾病例流行病学史、临床特征及病毒分子特征,发现SFTSV存在跨区域传播风险,提示非疫区需加强输入病例的早期识别与防控,为SFTS的临床诊疗和跨区域传播预警提供参考。

关键词: 重型发热伴血小板减少综合征, 临床特征, C基因型, 输入病例

Abstract: Severe fever with thrombocytopenia syndrome (SFTS) is an acute natural focal infectious disease caused by the SFTS virus (SFTSV), characterized by fever,gastrointestinal disturbances,thrombocytopenia,and leukopenia. This study reports a severe SFTS case of genotype C imported from Anhui Province to Shenzhen. The patient, an elderly male, resided in a rural area of Taihu County, Anqing City, Anhui Province (a known SFTS natural endemic focus with high tick vector density) and engaged in frequent farming activities two weeks prior to symptom onset, suggesting probable tick-borne transmission. The patient presented with acute onset of persistent fever, leukopenia, progressive thrombocytopenia (minimum 26×109/L), and multi-organ dysfunction (elevated hepatic and myocardial enzymes), meeting diagnostic criteria for severe SFTS. Laboratory testing confirmed SFTSV nucleic acid positivity in both blood and throat swab specimens (Ct values: 27 and 33, respectively), with IgM seropositivity and IgG seronegativity.The whole-genome sequencing results showed that the strain of the case belonged to the C genotype, which was closely related to the Hubei isolate. Supportive therapies including platelet transfusion, intravenous immunoglobulin, and albumin supplementation resulted in clinical recovery after 13 days of treatment. By systematically reviewing the epidemiological history, clinical manifestations, and molecular characteristics of SFTSV, this study highlights the potential risk of cross-regional transmission of SFTSV strains and emphasizes the necessity for non-endemic regions to strengthen early identification and prevention measures for imported SFTS cases, providing critical insights for clinical management and epidemiological surveillance of SFTS.

Key words: Severe fever with thrombocytopenia syndrome, Clinical features, Genotype C, Imported case

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