PMC4803711_01
Bone marrow smear findings for case 1. Red blood cells are ingested by a macrophage (May-Giemsa staining, x400 magnification)
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Fig1
A bone marrow aspiration smear showed that RBCs were ingested by macrophages (Fig. 1).
Tick biting the left popliteal fossa in case 1. The patient had red flares around the bite site
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Fig2
SFTS viral genome analysis by RT-PCR for case 1. Primer sets were prepared for the Japanese congenital SFTS virus. To increase detection sensitivity, two primer sets for different target areas were used. Lanes 1, 3, and 5 represent the samples (serum, urine, and pharyngeal swab, respectively) taken on the day after admission. Lanes 2 and 4 represent samples (serum and urine respectively) taken 3 days after the initial test. Lanes 6 and 7 contain a negative and positive control, respectively
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Fig3
Ten days after admission, the tick was identified as Haemaphysalis longicornis, and a definitive diagnosis of SFTS was made by conventional viral genome amplification analysis (Fig. 3; Yoshikawa et al.).
PMC4803711_02
Bone marrow smear findings for case 2. Platelets are ingested by a macrophage (May-Giemsa staining, x400 magnification)
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Fig4
A bone marrow biopsy and a smear test were performed, revealing that platelet cells were being ingested by macrophages (Fig. 4).
SFTS viral genome analysis by RT-PCR for case 2. Primer sets were prepared for the Japanese congenital SFTS virus. To increase detection sensitivity, two primer sets for different target areas were used. Lane 1 represents a frozen serum specimen, lane 2 contains a negative control, and lane 3 contains a positive control
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Fig5
As the patient had died, a frozen peripheral blood serum collected on hospital day 2 (3 days after disease onset) was tested for SFTS viral genome amplification via RT-PCR, and amplification was observed (Fig. 5).