title: Hantavirus pulmonary syndrome: radiographic findings in 16 patients.
abstract: OBJECTIVE
  To characterize chest radiographic features of Hantavirus pulmonary syndrome.
  
  
  METHODS
  Initial and follow-up chest radiographs from 16 patients with confirmed Hantavirus pulmonary syndrome were reviewed for radiographic findings of either cardiogenic pulmonary edema or pulmonary edema due to increased permeability of the alveolar capillary membranes.
  
  
  RESULTS
  Findings indicative of interstitial edema were present more frequently (14 [88%] of 16 patients) than is typically seen in adult respiratory distress syndrome (5%). Alveolar flooding subsequently developed in 11 (69%) of 16 patients and was not the peripheral pattern usually seen in the acute phase of adult respiratory distress syndrome. Overall mortality was 43%. Lung specimens obtained at autopsy showed a pattern of endothelial leak with minimal epithelial injury.
  
  
  CONCLUSIONS
  The lung disease caused by Hantavirus in these patients may explain the findings of interstitial edema and central alveolar filling atypical of adult respiratory distress syndrome. Recognition of the radiographic pattern will be important in identifying this apparently widespread cause of increased permeability pulmonary edema.
authors.affiliation: Department of Radiology, University of New Mexico School of Medicine, Albuquerque 87131-5336.
authors.forename: L H
authors.initials: LH
authors.lastname: Ketai
authors.forename: M R
authors.initials: MR
authors.lastname: Williamson
authors.forename: R J
authors.initials: RJ
authors.lastname: Telepak
authors.forename: H
authors.initials: H
authors.lastname: Levy
authors.forename: F T
authors.initials: FT
authors.lastname: Koster
authors.forename: K B
authors.initials: KB
authors.lastname: Nolte
authors.forename: S E
authors.initials: SE
authors.lastname: Allen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002044:Bunyaviridae Infections / Q000150:complications / Q000000981:diagnostic imaging*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006476:Orthohantavirus; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology; D013902:Radiography, Thoracic; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000000981:diagnostic imaging; D013577:Syndrome