[Respiratory manifestations of hemorrhagic fever with renal syndrome. Retrospective study of 129 cases in Champagne-Ardenne and Lorraine].
OBJECTIVE
The contradiction between airborne transmission of Puumala virus and the low rate of airway manifestations reported in hemorrhagic fever with renal syndrome (HFRS) caused by this virus led us to conduct this study to check whether the incidence of respiratory manifestations may have been underestimated.


METHODS
We retrospectively reviewed 129 consecutive cases of HFRS diagnosed between 1983 and 1995 in the eastern France.


RESULTS
Clinical manifestations of airway involvement and chest X-ray abnormalities were observed in 30% and 50% of the patients respectively. Analysing the radiological anomalies by serum creatinine level showed that in two-thirds of the cases (33% of all the HFRS cases) they were concomitant with acute renal failure and probably related to pulmonary edema, and that in one-third (17% of the HFRS cases) they were compatible with pneumonia. These cases of pneumonia could correspond to specific manifestations of the hantavirus Puumala at the site of penetration.


CONCLUSIONS
Although minimally expressive, respiratory manifestations were found to be more frequent than expected in hemorrhagic fever with renal syndrome. Incidence may have been formerly underestimated.
Service de Médecine interne, Hôpital Corvisart, Charleville-Mézières.
A T
AT
Nguyên
C
C
Penalba
P
P
Bernadac
S
S
Jaafar
M
M
Kessler
P
P
Canton
B
B
Hoen
D000293:Adolescent; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D005602:France / Q000453:epidemiology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000097:blood / Q000150:complications* / Q000635:transmission; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000821:virology*; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000821:virology*; D011859:Radiography; D012189:Retrospective Studies
D003404:Creatinine