title: Hantavirus infections for the clinician: from case presentation to diagnosis and treatment.
abstract: Hantaviruses cause Hantavirus Pulmonary Syndrome (HPS; also called Hantavirus Cardiopulmonary Syndrome) in the Americas and Hemorrhagic Fever with Renal Syndrome (HFRS) in Asia and Europe. In Scandinavia and northern Europe, a milder form of HFRS is prevalent, termed nephropathica epidemica (NE). HPS presents with acute respiratory failure, mild-moderate renal failure, thrombocytopenia, and reactive lymphocytosis. HFRS has pronounced renal dysfunction and less prominent respiratory involvement, with thrombocytopenia and hemorrhagic findings. Both syndromes have long-term sequelae. Common symptomatology is due to underlying pathophysiology, mainly increased vascular permeability and immune activation. Laboratory and imaging markers predicting disease severity are under research, allowing for more efficient patient management. Diagnosis is presumptive, based on typical clinical findings and patient history of likely rodent exposure. Confirmation of diagnosis is by serological testing and/or RT-PCR. Treatment is mainly comprised of cardiovascular, respiratory, and renal function support, with fluid and electrolyte homeostasis being crucial components of care. In HPS, the use of extracorporeal membrane oxygenation in decompensated patients has also shown to be beneficial.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Patras University General Hospital, Patras, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Sargianou
authors.forename: Dionysios Christos
authors.initials: DC
authors.lastname: Watson
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Chra
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
authors.forename: Ioannis
authors.initials: I
authors.lastname: Starakis
authors.forename: Charalambos
authors.initials: C
authors.lastname: Gogos
authors.forename: George
authors.initials: G
authors.lastname: Panos
mesh_terms: D001208:Asia; D005060:Europe; D006476:Orthohantavirus / Q000502:physiology*; D018778:Hantavirus Infections / Q000175:diagnosis* / Q000628:therapy* / Q000821:virology; D006801:Humans