# A Case of Severe Fever With Thrombocytopenia Syndrome Co-infected With Pseudomonas aeruginosa and Aspergillus fumigatus

## TL;DR

A patient with a severe tick-borne illness worsened due to co-infections with bacteria and fungus, highlighting the need for early detection and treatment.

## Contribution

Reports a fatal case of SFTS with co-infections and emphasizes the importance of early pathogen screening.

## Key findings

- The patient's condition rapidly deteriorated despite active treatment for SFTS and co-infections.
- mNGS confirmed the presence of SFTSV, Pseudomonas aeruginosa, and Aspergillus fumigatus post-mortem.
- Early pathogen screening and targeted treatment are critical for better outcomes in such cases.

## Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease with a high mortality rate. Co-infections with SFTS virus (SFTSV) and other pathogens can exacerbate the condition, leading to rapidly progressive multiple organ failure. We reported a case of SFTS complicated by Pseudomonas aeruginosa and Aspergillus fumigatus. Despite active symptomatic supportive treatment (including anti-virus, anti-infection, anti-antifungal treatment, liver protection, and other advanced life supports), the patient's condition deteriorated rapidly, leading to multiple organ failure. The patient was discharged home and died on the same day. The next day, her blood test results reported that SFTSV, Pseudomonas aeruginosa and Aspergillus fumigatus were detected through metagenomic next-generation sequencing (mNGS). It suggests that early pathogen screening and targeted anti-infective treatment are crucial for improving the prognosis.