Song G , 2004. Epidemiological study and prevention of hemorrhagic fever with renal syndrome. Chin J Publ Health 20: 766–768.
Avšič-Županc T , Saksida A , Korva M , 2019. Hantavirus infections. Clin Microbiol Infect 21S: e6–e16.
Zhiliang G et al., 2021. Expert consensus on prevention and treatment of hemorrhagic fever with renal syndrome. Chin J Infect Dis 39: 257–265.
Wang X et al., 2020. A case-control study on the risk factors for hemorrhagic fever with renal syndrome. BMC Infect Dis 20: 103.
Schonrich G , Rang A , Lutteke N , Raftery MJ , Charbonnel N , Ulrich RG , 2008. Hantavirus-induced immunity in rodent reservoirs and humans. Immunol Rev 225: 163–189.
Jiang H , Zheng X , Wang L , Du H , Wang P , Bai X , 2017. Hantavirus infection: a global zoonotic challenge. Virol Sin 32: 32–43.
Zhang YZ , Zou Y , Fu ZF , Plyusnin A , 2010. Hantavirus infections in humans and animals, China. Emerg Infect Dis 16: 1195–1203.
Heyman P et al., 2011. A five-year perspective on the situation of haemorrhagic fever with renal syndrome and status of the hantavirus reservoirs in Europe, 2005–2010. Euro Surveill 16: 19961.
Gonzalez JP , McCormick JB , Baudon D , Gautun JP , Meunier DY , Dournon E , Georges AJ , 1984. Serological evidence for Hantaan-related virus in Africa. Lancet 2: 1036–1037.
Brocato RL , Hooper JW , 2019. Progress on the prevention and treatment of hantavirus disease. Viruses 11: 610.
Rista E et al., 2017. Hemorrhagic fever with renal syndrome in Albania. Focus on predictors of acute kidney injury in HFRS. J Clin Virol 91: 25–30.
Moreno MS , Castelao RC , Braga RT , Lobo SM , 2007. Hantavirus pulmonary syndrome with multiple organ dysfunctions: case report [article in Portuguese]. Rev Bras Ter Intensiva 19: 494–498.
Wu G , Xia Z , Wang F , Wu J , Cheng D , Chen X , Liu H , Du Z , 2020. Investigation on risk factors of haemorrhagic fever with renal syndrome (HFRS) in Xuancheng City in Anhui Province, Mainland China. Epidemiol Infect 148: e248.
Connolly-Andersen AM , Rasmuson J , Öman M , Ahlm C , 2018. Mesenteric vein thrombosis following platelet transfusion in a patient with hemorrhagic fever with renal syndrome: a case report. TH Open 2: e261–e264.
Huang N , Liu N , Lu J , 2020. Peritonitis secondary to hemorrhagic fever with renal syndrome: a case report in GuangZhou China. BMC Infect Dis 20: 36.
Liu T , Yang W , Li K , Guo S , Tian M , Fang X , 2022. Hemorrhagic fever with renal syndrome complicated with acute pancreatitis and capillary cholangitis: a case report. Infect Drug Resist 15: 6755–6761.
Laine O , Mäkelä S , Mustonen J , Huhtala H , Szanto T , Vaheri A , Lassila R , Joutsi-Korhonen L , 2010. Enhanced thrombin formation and fibrinolysis during acute Puumala hantavirus infection. Thromb Res 126: 154–158.
Connolly-Andersen AM et al., 2015. Increased thrombopoiesis and platelet activation in hantavirus-infected patients. J Infect Dis 212: 1061–1069.
Lo SH , Chen PT , Yu WJ , Hsieh KS , Chen TC , 2021. Case report: spinal subarachnoid hemorrhage: a rare complication of hemorrhagic fever with renal syndrome. Am J Trop Med Hyg 104: 1432–1434.
Koskela S , Mäkelä S , Strandin T , Vaheri A , Outinen T , Joutsi-Korhonen L , Pörsti I , Mustonen J , Laine O , 2021. Coagulopathy in acute Puumala hantavirus infection. Viruses 13: 1553.
Sunbul M , Esen S , Fletcher TE , Dilek A , Guler N , Beeching NJ , Leblebicioglu H , 2016. A fatal case of healthcare associated Crimean-Congo haemorrhagic fever with severe disease and multi-organ failure. J Infect 72: 253–255.
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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.
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.
Song G , 2004. Epidemiological study and prevention of hemorrhagic fever with renal syndrome. Chin J Publ Health 20: 766–768.
Avšič-Županc T , Saksida A , Korva M , 2019. Hantavirus infections. Clin Microbiol Infect 21S: e6–e16.
Zhiliang G et al., 2021. Expert consensus on prevention and treatment of hemorrhagic fever with renal syndrome. Chin J Infect Dis 39: 257–265.
Wang X et al., 2020. A case-control study on the risk factors for hemorrhagic fever with renal syndrome. BMC Infect Dis 20: 103.
Schonrich G , Rang A , Lutteke N , Raftery MJ , Charbonnel N , Ulrich RG , 2008. Hantavirus-induced immunity in rodent reservoirs and humans. Immunol Rev 225: 163–189.
Jiang H , Zheng X , Wang L , Du H , Wang P , Bai X , 2017. Hantavirus infection: a global zoonotic challenge. Virol Sin 32: 32–43.
Zhang YZ , Zou Y , Fu ZF , Plyusnin A , 2010. Hantavirus infections in humans and animals, China. Emerg Infect Dis 16: 1195–1203.
Heyman P et al., 2011. A five-year perspective on the situation of haemorrhagic fever with renal syndrome and status of the hantavirus reservoirs in Europe, 2005–2010. Euro Surveill 16: 19961.
Gonzalez JP , McCormick JB , Baudon D , Gautun JP , Meunier DY , Dournon E , Georges AJ , 1984. Serological evidence for Hantaan-related virus in Africa. Lancet 2: 1036–1037.
Brocato RL , Hooper JW , 2019. Progress on the prevention and treatment of hantavirus disease. Viruses 11: 610.
Rista E et al., 2017. Hemorrhagic fever with renal syndrome in Albania. Focus on predictors of acute kidney injury in HFRS. J Clin Virol 91: 25–30.
Moreno MS , Castelao RC , Braga RT , Lobo SM , 2007. Hantavirus pulmonary syndrome with multiple organ dysfunctions: case report [article in Portuguese]. Rev Bras Ter Intensiva 19: 494–498.
Wu G , Xia Z , Wang F , Wu J , Cheng D , Chen X , Liu H , Du Z , 2020. Investigation on risk factors of haemorrhagic fever with renal syndrome (HFRS) in Xuancheng City in Anhui Province, Mainland China. Epidemiol Infect 148: e248.
Connolly-Andersen AM , Rasmuson J , Öman M , Ahlm C , 2018. Mesenteric vein thrombosis following platelet transfusion in a patient with hemorrhagic fever with renal syndrome: a case report. TH Open 2: e261–e264.
Huang N , Liu N , Lu J , 2020. Peritonitis secondary to hemorrhagic fever with renal syndrome: a case report in GuangZhou China. BMC Infect Dis 20: 36.
Liu T , Yang W , Li K , Guo S , Tian M , Fang X , 2022. Hemorrhagic fever with renal syndrome complicated with acute pancreatitis and capillary cholangitis: a case report. Infect Drug Resist 15: 6755–6761.
Laine O , Mäkelä S , Mustonen J , Huhtala H , Szanto T , Vaheri A , Lassila R , Joutsi-Korhonen L , 2010. Enhanced thrombin formation and fibrinolysis during acute Puumala hantavirus infection. Thromb Res 126: 154–158.
Connolly-Andersen AM et al., 2015. Increased thrombopoiesis and platelet activation in hantavirus-infected patients. J Infect Dis 212: 1061–1069.
Lo SH , Chen PT , Yu WJ , Hsieh KS , Chen TC , 2021. Case report: spinal subarachnoid hemorrhage: a rare complication of hemorrhagic fever with renal syndrome. Am J Trop Med Hyg 104: 1432–1434.
Koskela S , Mäkelä S , Strandin T , Vaheri A , Outinen T , Joutsi-Korhonen L , Pörsti I , Mustonen J , Laine O , 2021. Coagulopathy in acute Puumala hantavirus infection. Viruses 13: 1553.
Sunbul M , Esen S , Fletcher TE , Dilek A , Guler N , Beeching NJ , Leblebicioglu H , 2016. A fatal case of healthcare associated Crimean-Congo haemorrhagic fever with severe disease and multi-organ failure. J Infect 72: 253–255.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 2097 | 2097 | 84 |
Full Text Views | 200 | 200 | 3 |
PDF Downloads | 63 | 63 | 5 |