Severe Fever with Thrombocytopenia Syndrome and Acute Gastric Mucosal Lesions Confirmed Using Esophagogastroduodenoscopy

Severe fever with thrombocytopenia syndrome (SFTS) is known to cause gastrointestinal hemorrhaging; however, few reports have so far specified the site of the hemorrhaging or lesion characteristics. A 79-year-old man was admitted to the hospital with fever, anorexia, and diarrhea which was suspected to be due to gastroenteritis. On day 2, the patient developed hematemesis. Esophagogastroduodenoscopy revealed an acute gastric mucosal lesion. Further physical examination revealed an eschar, and the blood test was positive for SFTS virus nucleic acid. This case suggests that SFTS-associated gastrointestinal hemorrhage may be caused by acute gastritis. SFTS should therefore be considered in cases with fever, gastrointestinal symptoms, and thrombocytopenia.