1 - Pediatric Infectious Diseases Unit, Hospital de Dona Estefânia CHLC – EPE. Lisbon. Portugal
2 - Nacional Institute of Health Dr. Ricardo Jorge, Centre for Vectors and Infectious Diseases Research, Águas de Moura, Portugal
3 - Pediatric Unit, Hospital do Espírito Santo de Évora – EPE. Évora. Portugal
- Reunião internacional: 36THAnnual Meeting of European Society for Paediatric Infectious Diseases (ESPID) – Malmo, Sweden, May 28 – June 2; 2018
- Publicação sob a forma de resumo em poster
Introduction: Sandfly Fever Sicilian Virus (SFSV) is usually seen in summer months, especially in the Mediterranean area, and causes a self-limited benign disease. The only reference to this virus presence in our country was made in 1974 and was regarding antibody detection in a seroprevalence study. Since then, there are no other reports.
Case report: An 8-years-old, was admitted with fever (39o-38o), malaise, mild headache and weight loss (6%). He owns a dog and one week earlier he reported traveling to Ribatejo. Besides skin pallor and hepatosplenomegaly (4 cm), oral mucosa aphotic ulcers were noted from D3 to D7 and scaling of hands and feet from D15 to D20. Blood screening revealed microcytic and normochromic anemia (Hb 9.2 x 10 g/L, HTc 26.8%, MCV 74.7 fL), leucocytes 6.8x109/L, C-reactive protein 65.3 mg/L, erythrocyte sedimentation rate 84 mm/h and hypergammaglobulinemia. The cardiologic evaluation was normal. HSV1 were isolated from the mouth ulcers and the antistreptolysin O titer was high (664 to 1120 UI/mL). IgM and IgG antibodies for Sicilian virus were positive and diagnosis was confirmed by seroconversion. The blood SFSV molecular amplification was negative. Sandfly vector collection was performed at Ribatejo, but the two trapped specimens were negative for Phlebovirus RNA. Other causes for prolonged fever were excluded. After hospital discharge he maintained asthenia and intermittent vespertine fever for one month, being clinically improved afterwards.
Comments/ discussion: Although in Portugal sandflies and Toscana virus CSF infections were earlier identified, SFSV has never been linked to symptomatic infections. Sandfly fever known as the three days fever may cause prolonged fever and asthenia and complete recovery may last up to 30 days. However, in our case we cannot exclude that other co-infections might have had a role.
Key words: Phleboviruses, Prolonged febrile illness, Sandfly Fever Sicilian Virus.