ArticleBMC infectious diseases2026
CT-detected lymphadenopathy and prognostic markers in severe fever with thrombocytopenia syndrome: a retrospective study.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSevere fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral disease with substantial mortality in endemic regions. CT findings, particularly lymphadenopathy with perinodal fat stranding, may be under-recognized. We evaluated CT findings and factors associated with in-hospital mortality in an endemic setting.
methodsWe retrospectively reviewed 16 RT-qPCR-confirmed SFTS patients treated at Ehime Prefectural Central Hospital and Kagawa University Hospital (January 2013-December 2024). CT images were reviewed by a board-certified diagnostic radiologist and an infectious diseases physician for lymphadenopathy and perinodal fat stranding. Clinical and laboratory variables were compared between non-survivors and survivors using permutation tests with bootstrap 95% confidence intervals; categorical factors were assessed by univariable analysis.
resultsMedian age was 69 years (44-86), and 11 (68.8%) were male. CT showed lymphadenopathy with perinodal fat stranding in 15/16 (93.8%), with one case showing no lymphadenopathy. Two patients (12.5%) died in hospital. Lymph node size was not associated with mortality (difference [non-survivors - survivors], - 0.28 cm; 95% CI, - 0.54 to 0.84; P = 0.549). Non-survivors had higher aspartate aminotransferase (difference, 190.21 U/L; 95% CI, 37.36 to 343.50; P = 0.040) and lower platelet counts (difference, - 5.99 × 10³/µL; 95% CI, - 7.52 to - 4.40; P = 0.009). No categorical factor reached statistical significance (altered mental status, borderline; P = 0.050).
conclusionsIn this cohort, CT frequently revealed lymphadenopathy with perinodal fat stranding, an under-recognized pattern that may support earlier recognition of SFTS in patients with compatible clinical and epidemiological features. Additionally, elevated aspartate aminotransferase and decreased platelet counts were associated with in-hospital mortality in this cohort and may be useful as exploratory markers for early risk stratification.
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