title: Dobrava-Belgrade hantavirus infection mimics acute appendicitis.
abstract: Dobrava-Belgrade hantavirus infection mimicked acute appendicitis in a patient suffering from hemorrhagic fever with renal syndrome in Hungary. The 27-year-old man was admitted to the local hospital with severe abdominal pain localized mainly at the right lower quadrant of the abdomen and with fever, nausea, vomiting and bloody diarrhea. Based on these findings supported by computerized tomography acute perforated appendicitis was suspected and an explorative laparatomy was performed, which did not confirm the diagnosis. Next day he developed acute oliguric renal failure raising the possibility of hantavirus infection. Specific serum IgG and IgM antibodies against hantavirus were identified, and by molecular methods the presence of Dobrava-Belgrade virus was proven. This report describes a rare clinical manifestation of hemorrhagic fever with renal syndrome (HFRS), and shows that HFRS might be difficult to diagnose especially when symptoms mimick those of an acute abdominal inflammation.
authors.affiliation: Virological Research Group, Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary. jakabf@gamma.ttk.pte.hu
authors.forename: Ferenc
authors.initials: F
authors.lastname: Jakab
authors.forename: Judit
authors.initials: J
authors.lastname: Sebok
authors.forename: Zalán
authors.initials: Z
authors.lastname: Szántó
authors.forename: Dóra
authors.initials: D
authors.lastname: Hang
authors.forename: Marianna
authors.initials: M
authors.lastname: Imre
authors.forename: Viktória
authors.initials: V
authors.lastname: Németh
authors.forename: Mónika
authors.initials: M
authors.lastname: Madai
authors.forename: Miklós
authors.initials: M
authors.lastname: Oldal
authors.forename: Tamás
authors.initials: T
authors.lastname: Kovács
authors.forename: István
authors.initials: I
authors.lastname: Wittmann
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D001064:Appendicitis / Q000175:diagnosis; D003937:Diagnosis, Differential; D006476:Orthohantavirus / Q000276:immunology* / Q000302:isolation & purification; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D006814:Hungary; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M