ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Emergency: requires immediate attention
Bourbon virus disease
Print
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Bourbon virus disease

Print Images (1)
Contributors: Mukesh Patel MD, Zaw Min MD, FACP
Other Resources UpToDate PubMed

Synopsis

Bourbon virus is a newly described thogotovirus that is associated with a fatal febrile illness in a patient from Bourbon County, Kansas, in the United States. Ticks are the suspected vector, but this has yet to be conclusively proven, and the biology of Bourbon virus remains unknown. Other viruses in the genus Thogotovirus are associated with hard and soft ticks. Human infections due to Dhori virus, another Thogotovirus, have been described following laboratory exposure and resulted in encephalitis in 2 patients.

Because only one identified case of Bourbon virus infection has occurred to date, the understanding of the clinical manifestations of infection will likely continue to evolve with future infections. Infection developed in a previously healthy adult male who had known tick bites several days prior to the onset of nausea, weakness, and diarrhea. Fever, chills, headache, myalgias, arthralgias, and anorexia followed the next day, and by the fourth day, the patient became obtunded. Fever was persistent through at least the ninth day of illness, and the patient developed heart failure, respiratory failure, metabolic acidosis, acute kidney injury, and eventual cardiac arrest resulting in death.

Physical examination findings early in the illness included a papular rash, and later macular lesions. Petechiae occurred in association with progressive thrombocytopenia.

Laboratory findings included leukopenia, thrombocytopenia, transaminitis, hypokalemia, and hyponatremia. Acute kidney injury and lactic acidosis may occur as the disease progresses.

The geographic distribution of Bourbon virus is unknown as it has only been detected in the index patient who resided in Bourbon County, Kansas.

Codes

ICD10CM:
A93.8 – Other specified arthropod-borne viral fevers

SNOMEDCT:
90729005 – Thogoto virus

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

The clinical presentation and laboratory findings of Bourbon virus infection are nonspecific and may occur with numerous infectious and noninfectious diseases. Several tick-borne bacterial diseases may present similarly.

Infections:
Noninfectious diseases:

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Updated: 01/12/2016
Copyright © 2019 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Bourbon virus disease
Print 1 Images
Bourbon virus disease : Fatigue, Fever, Nausea/vomiting, Patient appears ill, Tick bite, WBC decreased, PLT decreased
Copyright © 2019 VisualDx®. All rights reserved.