Acute hantavirus infection presenting as haemolytic-uraemic syndrome (HUS): the importance of early clinical diagnosis

Eur J Clin Microbiol Infect Dis. 2018 Jan;37(1):135-140. doi: 10.1007/s10096-017-3113-6. Epub 2017 Oct 6.

Abstract

The European prototype of hantavirus, Puumala virus (PUUV), isolated from a common wild rodent, the bank vole (Myodes glareolus), causes nephropathia epidemica (NE). NE can perfectly mimic haemolytic-uraemic syndrome (HUS), progressing from an aspecific flu-like syndrome to acute kidney injury with thrombocytopaenia, and presenting with some signs of haemolytic anaemia and/or coagulopathy. Moreover, both NE and HUS can occur in local outbreaks. We report an isolated case of NE, initially referred for plasmapheresis for suspected HUS, although signs of overt haemolysis were lacking. Early suspicion of hantavirus infection, later confirmed by serology and reverse transcription polymerase chain reaction (RT-PCR), prevented subsequent excessive treatment modalities.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / virology
  • Animals
  • Arvicolinae / virology
  • Diagnosis, Differential
  • Hemolytic-Uremic Syndrome / diagnosis
  • Hemorrhagic Fever with Renal Syndrome / diagnosis*
  • Hemorrhagic Fever with Renal Syndrome / therapy
  • Hemorrhagic Fever with Renal Syndrome / virology
  • Humans
  • Male
  • Middle Aged
  • Puumala virus / isolation & purification*
  • Rodent Diseases / transmission*
  • Rodent Diseases / virology
  • Thrombocytopenia / virology