title: [Systemic hantavirus-infection in a comatose HIV patient].
abstract: METHODS
  A 40 year old, disoriented, HIV- and Hepatitis B positive male patient was admitted with 40.3 °C. Clinically he presented a sinustachycardia (160/min) and hypotension (70/60 mmHg).
  Laboratory analyses showed elevated infection parameters, azotemia, proteinuria and thrombopenia. CD(4+)T-helper cells: 320/µl (32 %), HIV RNA: <40 copies/ml, Hepatitis B DNA: 20800 copies/ml. Hantavirus serology (immunofluorescence antibody assay): 1:2048; serotype Puumala.
  An early-goal-directed therapy and antibiotic treatment with Piperacillin and Tazobactam was initiated. The patient developed a bipulmonal infiltrate and an acute respiratory distress syndrome (ARDS ) requiring tracheal intubation, as well as a triad of fever, renal failure and profound hemorrhagic symptoms. This led to the diagnosis of the Puumala infection. Due to the parallel HIV- and Hepatits B infection an antiretroviral therapy was initiated.
  
  
  CONCLUSIONS
  In summary the Puumala infection bears the potential for a severe multi-organ failure, which is not typical for this usually benign infection.
authors: Universitätsklinik II für Innere Medizin, Paracelsus Medizinische Universität Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Österreich. r.larbig@salk.at
authors: Robert
authors: R
authors: Larbig
authors: Clara
authors: C
authors: Lehman
authors: Dennis
authors: D
authors: Rottländer
authors: Sara
authors: S
authors: Reda
authors: Guido
authors: G
authors: Michels
authors: Uta C
authors: UC
authors: Hoppe
authors: Mathias
authors: M
authors: Kochanek
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003128:Coma / Q000175:diagnosis*; D003422:Critical Care; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D029262:Puumala virus; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000188:drug therapy; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy; D000078142:Tazobactam
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D010397:Penicillanic Acid; D000078142:Tazobactam; D010878:Piperacillin