Research progress in diagnosis and differential diagnosis of severe fever with thrombocytopenia syndrome and hemorrhagic fever with renal syndrome

doi:10.3969/j.issn.1674-8115.2023.11.015

Abstract

Abstract:

Severe fever with thrombocytopenia syndrome (SFTS) and hemorrhagic fever with renal syndrome (HFRS) are infectious diseases. The epidemic of these two diseases can seriously affect human life and health, and is also a public health problem currently facing in the world. Due to the uneven level of medical development around the world, many doctors have insufficient understanding of these two diseases, which is likely to lead to missed diagnosis or misdiagnosis, and the patients are not treated correctly, which leads to aggravation of the disease and affects their prognosis. Clinically, the diagnosis of SFTS and HFRS mainly depends on the results of pathogenic examination and serological examination, but many medical institutions have not carried out these two examinations. Therefore, if epidemiological and clinical characteristics can be used to diagnose and differentiate these two diseases, it will help guide clinical practice. This paper reviews the research progress in the diagnosis and differential diagnosis of SFTS and HFRS at home and abroad in recent years.

Key words: severe fever with thrombocytopenia syndrome (SFTS), hemorrhagic fever with renal syndrome (HFRS), diagnosis, differential diagnosis

CLC Number:

R511

YAN Wenyue, LI Qiang. Research progress in diagnosis and differential diagnosis of severe fever with thrombocytopenia syndrome and hemorrhagic fever with renal syndrome[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(11): 1457-1462.

Figures/Tables 2

TrendMD

References 30

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Clinical symptom/sign	SFTS patient		HFRS patient
Clinical symptom/sign	Overall number of people	n (%)	Overall number of people	n (%)
Fever	2 122	2 118 (99.8)	329	325 (98.8)
Feeble	2 184	2 091 (95.7)	108	84 (77.8)
Myalgia	2 184	1 756 (80.4)	108	67 (62.0)
Headache	2 775	483 (17.4)	1 078	699 (64.8)
Arthralgia	2 691	158 (5.9)	694	228 (32.9)
Cough	2 180	1 092 (50.1)	419	59 (14.1)
Nausea	2 713	1 938 (71.4)	1 078	574 (53.2)
Vomiting	2 691	977 (36.3)	1 078	475 (44.1)
Diarrhoea	2 775	856 (30.8)	1 078	211 (19.6)
Abdominal pain	2 691	302 (11.2)	1 078	293 (27.2)
Facial flushing	284	28 (9.9)	811	330 (40.7)
Conjunctival congestion	595	44 (7.4)	1 078	444 (41.2)
Redness of neck	284	19 (6.7)	427	140 (32.8)
Petechia	2 691	119 (4.4)	694	136 (19.6)
Redness of chest	284	10 (3.5)	427	110 (25.8)
Haemoptysis	2 687	84 (3.1)	400	3 (0.8)
Hematuria	2 100	8 (0.4)	329	89 (27.1)
Lymphadenopathy	2 771	1 396 (50.4)	365	4 (1.1)
Oliguria	284	24 (8.5)	683	211 (30.9)
Icterus	595	3 (0.5)	659	18 (2.7)

Clinical symptom/sign	SFTS patient		HFRS patient
Clinical symptom/sign	Overall number of people	n (%)	Overall number of people	n (%)
Fever	2 122	2 118 (99.8)	329	325 (98.8)
Feeble	2 184	2 091 (95.7)	108	84 (77.8)
Myalgia	2 184	1 756 (80.4)	108	67 (62.0)
Headache	2 775	483 (17.4)	1 078	699 (64.8)
Arthralgia	2 691	158 (5.9)	694	228 (32.9)
Cough	2 180	1 092 (50.1)	419	59 (14.1)
Nausea	2 713	1 938 (71.4)	1 078	574 (53.2)
Vomiting	2 691	977 (36.3)	1 078	475 (44.1)
Diarrhoea	2 775	856 (30.8)	1 078	211 (19.6)
Abdominal pain	2 691	302 (11.2)	1 078	293 (27.2)
Facial flushing	284	28 (9.9)	811	330 (40.7)
Conjunctival congestion	595	44 (7.4)	1 078	444 (41.2)
Redness of neck	284	19 (6.7)	427	140 (32.8)
Petechia	2 691	119 (4.4)	694	136 (19.6)
Redness of chest	284	10 (3.5)	427	110 (25.8)
Haemoptysis	2 687	84 (3.1)	400	3 (0.8)
Hematuria	2 100	8 (0.4)	329	89 (27.1)
Lymphadenopathy	2 771	1 396 (50.4)	365	4 (1.1)
Oliguria	284	24 (8.5)	683	211 (30.9)
Icterus	595	3 (0.5)	659	18 (2.7)

Indicator	Reference range^①	SFTS patient	HFRS patient
White blood cell count/(μL^-1)	4 500‒11 000	2 501.9 (n=1 142)	11 891.2 (n=784)
Platelet/(×10⁹ L^-1)	150‒400	63.7 (n=1 142)	56.0 (n=784)
Hemoglobin/(g·dL^-1)	11.7‒16.1	13.2 (n=551)	13.9 (n=419)
Blood urea nitrogen/(mg·dL^-1)	8.0‒23.0	24.0 (n=57)	41.2 (n=419)
Creatinine/(mg·dL^-1)	0.6‒1.1	1.2 (n=240)	2.8 (n=419)
Glutamic-oxaloacetic transaminase/(IU·L^-1)	5‒45	281.0 (n=240)	323.6 (n=35)
Glutamic-pyruvic transaminase/(IU·L^-1)	10‒40	100.6 (n=240)	137.6 (n=35)
Lactate dehydrogenase/(IU·L^-1)	263‒450	1 093.3 (n=240)	1 331.0 (n=35)
Creatine kinase/(IU·L^-1)	32‒269	1 839.7 (n=240)	732.5 (n=35)
C-reactive protein/(mg·L^-1)	0‒3	18.1 (n=240)	28.0 (n=419)

Indicator	Reference range^①	SFTS patient	HFRS patient
White blood cell count/(μL^-1)	4 500‒11 000	2 501.9 (n=1 142)	11 891.2 (n=784)
Platelet/(×10⁹ L^-1)	150‒400	63.7 (n=1 142)	56.0 (n=784)
Hemoglobin/(g·dL^-1)	11.7‒16.1	13.2 (n=551)	13.9 (n=419)
Blood urea nitrogen/(mg·dL^-1)	8.0‒23.0	24.0 (n=57)	41.2 (n=419)
Creatinine/(mg·dL^-1)	0.6‒1.1	1.2 (n=240)	2.8 (n=419)
Glutamic-oxaloacetic transaminase/(IU·L^-1)	5‒45	281.0 (n=240)	323.6 (n=35)
Glutamic-pyruvic transaminase/(IU·L^-1)	10‒40	100.6 (n=240)	137.6 (n=35)
Lactate dehydrogenase/(IU·L^-1)	263‒450	1 093.3 (n=240)	1 331.0 (n=35)
Creatine kinase/(IU·L^-1)	32‒269	1 839.7 (n=240)	732.5 (n=35)
C-reactive protein/(mg·L^-1)	0‒3	18.1 (n=240)	28.0 (n=419)

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