Workup
Laboratory Studies
The following laboratory tests may be used in the workup of infections caused by viruses from the genus Thogotovirus:
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Complete blood cell (CBC) count, which is described only as abnormal in the single case report of Bourbon virus infection [8]
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Liver function tests
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Complete metabolic panel
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Blood and urine cultures to rule out bacterial infections
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Polymerase chain reaction (PCR) of blood to evaluate for other tick-related illnesses like ehrlichiosis or anaplasmosis
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Advanced molecular studies (ie, next-generation sequencing for viral genome sequencing, reverse-transcriptase PCR [RT-PCR], phylogenetic analyses) have been used in the workup of Bourbon virus infection [8]
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Imaging Studies
Chest radiography may be used to detect complications as seen cases with multiorgan failure and potential lung injury.
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Other Tests
No specific diagnostic test is used to evaluate suspected Bourbon virus infection. The CDC recommends that the healthcare practitioner contact the state health department regarding the possibility of pursuing an investigational protocol for this purpose. [12]
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Media Gallery
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Electron microscopic images of novel Thogotovirus isolate. Filamentous (A) and spherical (B) virus particles with distinct surface projection are visible in culture supernatant that was fixed in 2.5% paraformaldehyde. Thin-section specimens (C and D), fixed in 2.5% glutaraldehyde, show numerous extracellular virions with slices through strands of viral nucleocapsids. Arrows indicate virus particles that have been endocytosed. Scale bars indicate 100 nm. Courtesy of the CDC.
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