The Diagnosis of Severe Fever with Thrombocytopenia Syndrome Using Metagenomic Next-Generation Sequencing: Case Report and Literature Review

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an infectious disease caused by a bunyaviridae virus. Its main clinical manifestation is fever with thrombocytopenia, which may be accompanied by other clinical symptoms. Here, we report a patient diagnosed with SFTS using metagenomic next-generation sequencing (mNGS). Case Presentation: A 56-year-old female patient was hospitalized with intermittent diarrhea and fever. She visited a local clinic for treatment, but instead of improving, the symptoms progressed to unconsciousness. Diagnosis: Using mNGS, we isolated the bunyaviridae virus and several other pathogens from the patient's blood samples to confirm the diagnosis. Interventions: The patient was treated with symptomatic and supportive therapy, including intravenous human gamma-globulin (20 g/d), platelet transfusion, platelet elevation (subcutaneous injection of recombinant human thrombopoietin, 15,000 IU), white blood cell elevation (subcutaneous injection of recombinant human granulocyte colony-stimulating factor, 200 ug, qd); and antibiotic (cefoperazone sodium and tazobactam sodium, 2 g, q8h), antiviral (ganciclovir, 250 mg, q12h), and antifungal therapy (voriconazole for injection, 0.2 g, q12h). After ten days of treatment, the patient's condition gradually improved. Conclusion: Compared to traditional detection methods, mNGS has many advantages. It can quickly identify the pathogen when the patient's clinical manifestations are complex and difficult to diagnose, resulting in the formulation of an effective treatment.