Hantavirus: Difference between revisions
From IDWiki
No edit summary |
(→) |
||
Line 1: | Line 1: | ||
− | == |
+ | ==Background== |
− | * |
+ | *Enveloped, single-stranded RNA virus within the order [[Bunyavirales]], family [[Hantaviridae]] |
− | * |
+ | *Acquired by inhalation of contaminated rodent urine or feces, and possibly by bites |
− | * |
+ | *Essentially worldwide, though New World viruses tend to cause hantavirus pulmonary syndrome and Old World viruses tend to cause hemorrhagic fever with renal syndrome |
− | == |
+ | ==Clinical Manifestations== |
− | * |
+ | *Incubation period of [[Usual incubation period::14 days]] (range [[Incubation period range::5 to 42 days]]) |
− | === |
+ | ===Hemorrhagic Fever With Renal Syndrome (HFRS)=== |
− | * |
+ | *Caused by Old World hantaviruses, such as Hantaan, Dobrava, Seoul, Puumala, and other Old World hantaviruses |
− | * |
+ | *[[Fever]], [[thrombocytopenia]], and [[AKI]] caused by [[acute interstitial nephritis]] |
− | * |
+ | *Also headache, abdominal pain, low back pain, dizziness, and blurred vision |
− | * |
+ | *Can have conjunctival injection and petechiae on upper trunk and soft palate |
− | * |
+ | *Febrile phase lasts 4 to 7 days of acute, severe illness, followed by hypotensive, oliguric, and polyuric phases |
− | * |
+ | *Leukocytosis and thrombocytopenia seen on CBC |
− | * |
+ | *Mortality up to 5% |
− | === |
+ | ===Hantavirus Pulmonary Syndrome (HPS)=== |
− | * |
+ | *Caused by New World hantaviruses such as Sin Nombre, Bayou, and Black Creek Canal |
− | * |
+ | *Prodrome of fever followed 4 to 5 days later by shock and pulmonary edema |
− | ** |
+ | **Prodrome may include myalgias, abdominal pain, and gastrointestinal symptoms |
− | ** |
+ | **Respiratory failure can develop quickly |
− | * |
+ | *Elevated hematocrit (from third-spacing), leukocytosis, atypical lymphocytes, mild thrombocytopenia, prolonged PTT, and mild elevations in AST and LDH |
− | * |
+ | *Creatinine may be elevated, but not as severe as HFRS |
− | == |
+ | ==Differential Diagnosis== |
− | * |
+ | *HPS: other causes of unexplained [[pulmonary edema]] |
− | == |
+ | ==Diagnosis== |
− | * |
+ | *Serology usually positive by presentation (both IgM and IgG) |
− | * |
+ | *PCR or immunohistochemical staining are both possible |
− | * |
+ | *Viral culture is difficult |
− | == |
+ | ==Management== |
− | * |
+ | *Supportive |
[[Category:Infectious diseases]] |
[[Category:Infectious diseases]] |
Revision as of 09:33, 24 August 2020
Background
- Enveloped, single-stranded RNA virus within the order Bunyavirales, family Hantaviridae
- Acquired by inhalation of contaminated rodent urine or feces, and possibly by bites
- Essentially worldwide, though New World viruses tend to cause hantavirus pulmonary syndrome and Old World viruses tend to cause hemorrhagic fever with renal syndrome
Clinical Manifestations
- Incubation period of 14 days (range 5 to 42 days)
Hemorrhagic Fever With Renal Syndrome (HFRS)
- Caused by Old World hantaviruses, such as Hantaan, Dobrava, Seoul, Puumala, and other Old World hantaviruses
- Fever, thrombocytopenia, and AKI caused by acute interstitial nephritis
- Also headache, abdominal pain, low back pain, dizziness, and blurred vision
- Can have conjunctival injection and petechiae on upper trunk and soft palate
- Febrile phase lasts 4 to 7 days of acute, severe illness, followed by hypotensive, oliguric, and polyuric phases
- Leukocytosis and thrombocytopenia seen on CBC
- Mortality up to 5%
Hantavirus Pulmonary Syndrome (HPS)
- Caused by New World hantaviruses such as Sin Nombre, Bayou, and Black Creek Canal
- Prodrome of fever followed 4 to 5 days later by shock and pulmonary edema
- Prodrome may include myalgias, abdominal pain, and gastrointestinal symptoms
- Respiratory failure can develop quickly
- Elevated hematocrit (from third-spacing), leukocytosis, atypical lymphocytes, mild thrombocytopenia, prolonged PTT, and mild elevations in AST and LDH
- Creatinine may be elevated, but not as severe as HFRS
Differential Diagnosis
- HPS: other causes of unexplained pulmonary edema
Diagnosis
- Serology usually positive by presentation (both IgM and IgG)
- PCR or immunohistochemical staining are both possible
- Viral culture is difficult
Management
- Supportive