Bourbon virus disease
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.
A93.8 – Other specified arthropod-borne viral fevers
90729005 – Thogoto virus
- Rocky Mountain spotted fever
- Human ehrlichioses
- Tick-borne relapsing fever
- Louse-borne relapsing fever
- Q fever
- Typhoid fever
- Infectious mononucleosis
- Cytomegalovirus infection
- Human immunodeficiency virus (especially acute infection)
- Dengue fever
- Chikungunya fever
- Heartland virus infection
- Acute viral hepatitis (eg, hepatitis A, B, C)