{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:20:33Z","timestamp":1793132433263,"version":"4.5.0"},"reference-count":40,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infection with a high case fatality rate. The serious clinical features need to be further defined. We performed a retrospective analysis among SFTS patients in South Korea during 2016\u20132021 to update the current status. The basic epidemiology of all reported cases was analyzed, and the detailed clinical data of the subjects were further collected from study hospitals selected in terms of their geographic location and capability of SFTS care. Cases of SFTS were reported across the country and were greatly increased since the initial endemic phase, even under the passive surveillance system. The case fatality rate remained at approximately 16.8%. Coinfections at admission were present in 7.8% of the patients. Major complications included bleeding (15.2%), hemophagocytic lymphohistiocytosis (6.7%), bacteremia or candidemia (4.0%), and invasive pulmonary aspergillosis (1.7%). It took a median 4\u2009days from the onset of illness to hospital admission. Rapid clinical deterioration was observed with a median 1\u2009day for intensive care unit admission, 3\u2009days for mechanical ventilation, 4\u2009days for renal replacement therapy, and 5\u2009days for death, all after the hospitalization. Multivariate analysis showed that the fatality was associated with older age, bacteremia, or candidemia during hospitalization, and the presence of several variables at admission such as fever, altered mentality, aspartate aminotransferase &gt;200\u2009IU\/L, serum creatinine level &gt;1.2\u2009mg\/dL, and prolonged prothrombin time and activated partial thromboplastin time. Treatment options to improve clinical outcomes are limited, despite best supportive care. Specific treatment is urgently needed to change the fatal course.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0062","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T13:37:56Z","timestamp":1720532276000},"page":"661-670","source":"Crossref","is-referenced-by-count":13,"title":["Severe Fever with Thrombocytopenia Syndrome in South Korea, 2016\u20132021: Clinical Features of Severe Progression and Complications"],"prefix":"10.4269","volume":"111","author":[{"given":"Minkyeong","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine & Boramae Medical Center, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine & Boramae Medical Center, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Keun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Gyu","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyeong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Soon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Seop","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Bum","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Ah","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Keimyung University School of Medicine, Daegu, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Hyok","family":"Jeon","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon-Sook","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Hee","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, GangNeung Asan Hospital, GangNeung, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sook-In","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Hee","family":"Baik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cheju Halla Hospital, Jeju, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namhee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Seoul National University College of Medicine & Boramae Medical Center, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihwan","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine & Boramae Medical Center, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Won","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine & Boramae Medical Center, Seoul, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","year":"2023"},{"key":"b2","series-title":"N Engl J Med","first-page":"1523","article-title":"Fever with thrombocytopenia associated with a novel bunyavirus in China","volume":"364","author":"Yu","year":"2011"},{"key":"b3","series-title":"Viruses","first-page":"1213","article-title":"Clinical update of severe fever with thrombocytopenia syndrome","volume":"13","author":"Seo","year":"2021"},{"key":"b4","series-title":"Emerg Infect Dis","first-page":"1029","article-title":"Endemic severe fever with thrombocytopenia syndrome, Vietnam","volume":"25","author":"Tran","year":"2019"},{"key":"b5","series-title":"Emerg Infect Dis","first-page":"1878","article-title":"Genotypic heterogeneity of Orientia tsutsugamushi in scrub typhus patients and thrombocytopenia syndrome co-infection, Myanmar","volume":"26","author":"Win","year":"2020"},{"key":"b6","series-title":"Emerg Infect Dis","first-page":"1513","article-title":"Serologic evidence of severe fever with thrombocytopenia syndrome virus and related viruses in Pakistan","volume":"26","author":"Zohaib","year":"2020"},{"key":"b7","series-title":"Emerg Microbes Infect","first-page":"148","article-title":"The first discovery of severe fever with thrombocytopenia syndrome virus in Taiwan","volume":"9","author":"Lin","year":"2020"},{"key":"b8","series-title":"Exp Mol Med","first-page":"713","article-title":"Severe fever with thrombocytopenia syndrome virus: Emerging novel phlebovirus and their control strategy","volume":"53","author":"Casel","year":"2021"},{"key":"b9","series-title":"Emerg Infect Dis","first-page":"1892","article-title":"Severe fever with thrombocytopenia syndrome, South Korea, 2012","volume":"19","author":"Kim","year":"2013"},{"key":"b10","year":"2022"},{"key":"b11","series-title":"PLoS Negl Trop Dis","first-page":"e0005264","article-title":"Severe fever with thrombocytopenia syndrome in South Korea, 2013\u20132015","volume":"10","author":"Choi","year":"2016"},{"key":"b12","series-title":"Clin Microbiol Rev","first-page":"788","article-title":"Updated review of blood culture contamination","volume":"19","author":"Hall","year":"2006"},{"key":"b13","series-title":"Cumitch 1C, Blood Cultures IV","author":"Baron","year":"2005"},{"key":"b14","series-title":"Clin Infect Dis","first-page":"S121","article-title":"EORTC\/MSGERC definitions of invasive fungal diseases: Summary of activities of the Intensive Care Unit Working Group","volume":"72","author":"Bassetti","year":"2021"},{"key":"b15","series-title":"Pediatr Blood Cancer","first-page":"124","article-title":"HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis","volume":"48","author":"Henter","year":"2007"},{"key":"b16","series-title":"Emerg Infect Dis","first-page":"872","article-title":"Seroprevalence of severe fever with thrombocytopenia syndrome virus antibodies in rural areas, South Korea","volume":"24","author":"Han","year":"2018"},{"key":"b17","series-title":"Infect Chemother","first-page":"337","article-title":"Seroprevalence of severe fever with thrombocytopenia syndrome in the agricultural population of Jeju Island, Korea, 2015\u20132017","volume":"51","author":"Yoo","year":"2019"},{"key":"b18","series-title":"J Korean Med Sci","first-page":"29","article-title":"Seroprevalence of severe fever with thrombocytopenia syndrome in southeastern Korea, 2015","volume":"32","author":"Kim","year":"2017"},{"key":"b19","series-title":"J Agric Med Community Health","first-page":"162","article-title":"Seroprevalence and risk factors for severe fever with thrombocytopenia syndrome among the Korea National Park Service Workers","volume":"46","author":"Kim","year":"2021"},{"key":"b20","series-title":"Vector Borne Zoonotic Dis","first-page":"284","article-title":"Prevalence of severe fever with thrombocytopenia syndrome virus in ticks collected from national parks in Korea","volume":"19","author":"Jo","year":"2019"},{"key":"b21","series-title":"Emerg Infect Dis","first-page":"692","article-title":"Severe fever with thrombocytopenia syndrome, Japan, 2013\u20132017","volume":"26","author":"Kobayashi","year":"2020"},{"key":"b22","series-title":"Lancet Infect Dis","first-page":"1127","article-title":"Epidemiological and clinical features of laboratory-diagnosed severe fever with thrombocytopenia syndrome in China, 2011\u201317: A prospective observational study","volume":"18","author":"Li","year":"2018"},{"key":"b23","series-title":"Clin Infect Dis","first-page":"1292","article-title":"Case-fatality ratio and effectiveness of ribavirin therapy among hospitalized patients in China who had severe fever with thrombocytopenia syndrome","volume":"57","author":"Liu","year":"2013"},{"key":"b24","series-title":"Lancet Infect Dis","first-page":"763","article-title":"Severe fever with thrombocytopenia syndrome, an emerging tick-borne zoonosis","volume":"14","author":"Liu","year":"2014"},{"key":"b25","series-title":"PLoS One","first-page":"e0165207","article-title":"Epidemiological and clinical features of severe fever with thrombocytopenia syndrome in Japan, 2013\u20132014","volume":"11","author":"Kato","year":"2016"},{"key":"b26","series-title":"BMC Infect Dis","first-page":"1253","article-title":"Clinical features of severe fever with thrombocytopenia syndrome and analysis of risk factors for mortality","volume":"21","author":"He","year":"2021"},{"key":"b27","series-title":"BMC Infect Dis","first-page":"575","article-title":"Severe fever with thrombocytopenia syndrome: A systematic review and meta-analysis of epidemiology, clinical signs, routine laboratory diagnosis, risk factors, and outcomes","volume":"20","author":"He","year":"2020"},{"key":"b28","series-title":"Int J Infect Dis","first-page":"646","article-title":"Invasive pulmonary aspergillosis is a frequent complication in patients with severe fever with thrombocytopenia syndrome: A retrospective study","volume":"105","author":"Xu","year":"2021"},{"key":"b29","series-title":"BMC Infect Dis","first-page":"904","article-title":"Clinical feature of severe fever with thrombocytopenia syndrome (SFTS)-associated encephalitis\/encephalopathy: A retrospective study","volume":"21","author":"Xu","year":"2021"},{"key":"b30","series-title":"Am J Trop Med Hyg","first-page":"1259","article-title":"Coinfection of severe fever with thrombocytopenia syndrome and scrub typhus in patients with tick-borne illness","volume":"101","author":"Ra","year":"2019"},{"key":"b31","series-title":"Emerg Infect Dis","first-page":"1992","article-title":"Severe fever with thrombocytopenia syndrome in patients suspected of having scrub typhus","volume":"22","author":"Wi","year":"2016"},{"key":"b32","series-title":"Osong Public Health Res Perspect","first-page":"4","article-title":"Spatial distribution analysis of scrub typhus in Korea","volume":"4","author":"Jin","year":"2013"},{"key":"b33","series-title":"EBioMedicine","first-page":"103591","article-title":"Clinical efficacy and safety evaluation of favipiravir in treating patients with severe fever with thrombocytopenia syndrome","volume":"72","author":"Yuan","year":"2021"},{"key":"b34","series-title":"Yonsei Med J","first-page":"867","article-title":"Effect of early plasma exchange on survival in patients with severe fever with thrombocytopenia syndrome: A multicenter study","volume":"58","author":"Oh","year":"2017"},{"key":"b35","series-title":"PLoS Negl Trop Dis","first-page":"e0009128","article-title":"Effects of steroid therapy in patients with severe fever with thrombocytopenia syndrome: A multicenter clinical cohort study","volume":"15","author":"Jung","year":"2021"},{"key":"b36","series-title":"Front Immunol","first-page":"1118039","article-title":"Effect of intravenous immunoglobulin therapy on the prognosis of patients with severe fever with thrombocytopenia syndrome and neurological complications","volume":"14","author":"Liu","year":"2023"},{"key":"b37","series-title":"JAMA","first-page":"2323","article-title":"International study of the prevalence and outcomes of infection in intensive care units","volume":"302","author":"Vincent","year":"2009"},{"key":"b38","series-title":"Clin Infect Dis","first-page":"1491","article-title":"Invasive pulmonary aspergillosis in patients with severe fever with thrombocytopenia syndrome","volume":"70","author":"Bae","year":"2020"},{"key":"b39","series-title":"Infect Chemother","first-page":"225","article-title":"A case of acute cerebral aspergillosis complicating influenza A\/H1N1pdm 2009","volume":"45","author":"Kim","year":"2013"},{"key":"b40","series-title":"Immunol Invest","first-page":"751","article-title":"Aspergillosis in the \u201cnonimmunocompromised\u201d host","volume":"40","author":"Stevens","year":"2011"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/3\/article-p661.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/3\/article-p661.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/3\/article-p661.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T20:01:48Z","timestamp":1725480108000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/3\/article-p661.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,4]]},"references-count":40,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0062","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,4]]}}}