Case Report: Multiple Organ Failure Caused by Hemorrhagic Fever with Renal Syndrome

Rui Wang Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;

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Xiang-yang Zhao Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;

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Xiao-jun Liu Department of Nosocomial Infection Management, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China

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Miao Zhang Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;

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Yan-ting Sun Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;

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Xiao Ning Department of Nosocomial Infection Management, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China

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Jian Xu Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;

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Chan-yuan Bu Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;

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ABSTRACT.

Hemorrhagic fever with renal syndrome (HFRS), a natural epidemic disease caused by hantavirus (HV), is one of the viral diseases that pose a major threat to our health. Considering the increasing number of atypical-onset cases reported in some countries, it is important to be familiar with the symptoms of HFRS and the signs of HV infection. This report describes the case of a 55-year-old man with complaints of fever, vomiting, and diarrhea. His symptoms showed no significant improvement after routine anti-infective, antipyretic, and other symptomatic supportive treatments administered at a local clinic. During these treatments, the patient had progressive oliguria; after 3 days, he also developed multiple organ failures, such as the liver and kidney, and was examined for positive serum IgM antibodies to hemorrhagic fever during treatment at our hospital. The patient was finally diagnosed with HFRS followed by multiple organ failure. After antiviral therapy, including ribavirin, piperacillin, and tazobactam, continuous renal replacement therapy, fluid metabolism adjustment, and related supportive therapy were administered, which improved his liver and kidney function. He was discharged on the 25th day after hospitalization. It is difficult to manage patients who develop multiple organ failure after HFRS. Moreover, this condition is rare in clinical settings, with fever being the initial indication. For diseases with unknown origin such as refractory fever and diarrhea, it is crucial to differentiate them from common pathogenic infection and HV infections to provide timely treatment that improves the prognosis of patients.

Author Notes

Address correspondence to Chan-yuan Bu. E-mail: buchanyuan1109@163.com

These authors contributed equally to this work.

Disclosure: This study was approved by the ethics committee of Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University (KYLL-KS-2023001).

Author’s addresses: Rui Wang, Xiang-yang Zhao, Miao Zhang, Yan-ting Sun, Jian Xu, and Chan-yuan Bu, Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China, E-mails: wangrui_628@163.com, zxy_zxy2021@126.com, 18669797782@163.com, yantingsun716@163.com, xujian34302@163.com, and buchanyuan1109@163.com. Xiao-jun Liu and Xiao Ning, Department of Nosocomial Infection Management, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China, E-mail: gsyylxj@163.com and 1043859825@qq.com.

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