Unraveling the complexities: A comprehensive review of severe fever with thrombocytopenia syndrome and its associated complications.

Severe fever with thrombocytopenia syndrome (SFTS), caused by Dabie bandavirus (DBV), is an emerging vector-borne infection with significant global health implications, particularly in East Asia. In recent years, its geographic footprint has expanded beyond traditional endemic regions, raising global concern due to high morbidity and variable case-fatality rates of up to 30%. Clinically, SFTS presents with an acute onset of high fever, thrombocytopenia, leukocytopenia, headache, and gastrointestinal disturbances. In severe cases, rapid progression may lead to life-threatening complications, including myocarditis, neurological disorders, invasive pulmonary aspergillosis (IPA), secondary infections, systemic inflammatory response syndrome (SIRS), hemophagocytic lymphohistiocytosis (HLH), and ultimately multi-organ failure (MOF). This review synthesizes recent advances in virology, pathophysiological mechanisms, diagnostic strategies, and therapeutic interventions for DBV infections. Special attention is given to the complications most commonly associated with poor prognoses and fatal outcomes in patients with SFTS, alongside future outlooks for research and public health preparedness to mitigate the growing global burden of this high-priority tick-borne disease.