Systemische Hantavirus-Infektion bei einem komatösen HIV Patienten

Larbig, Robert; Lehman, Clara; Rottländer, Dennis; Reda, Sara; Michels, Guido; Hoppe, Uta C.; Kochanek, Moritz

doi:10.1007/s10354-012-0143-7

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…There are few reports of immunodeficiency patients infected with Hantavirus. Robert Larbig et al reported that an HIV patient was infected with Puumala virus and had HFRS [ 18 ]. The patient had fever, sore limbs, thrombocytopenia, hypotension, impaired renal function, and disorientation encephalopathy.…”

Section: Discussionmentioning

confidence: 99%

Central nervous system infection with Seoul Orthohantavirus in a child after hematopoietic stem cell transplantation: a case report

Liu

et al. 2022

Virol J

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Background Patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) are prone to complicate viral infection. Central nervous system (CNS) involvement caused by the viruses is rare but with poor prognosis. Hantavirus, which usually cause hemorrhagic fever with renal syndrome (HFRS), and none case has been reported about these infection in allo-HSCT patients. Case presentation In August 2021, a 13-year-old male child developed intermittent fever and refractory hypotension after allo-HSCT. Magnetic resonance imaging of the head revealed abnormal signal foci in the left midbrain cerebral peduncle and bilateral thalamus. His family reported traces of mouse activity in the patient’s home kitchen. HFRS was suspected, but with no significant kidney damage. The specific immunoglobulin (Ig) G and M of hantavirus were negative. The metagenomic next-generation sequencing (mNGS) detected Seoul Orthohantavirus (SEOV) sequences directly in cerebrospinal fluid and blood. Conclusions Allo-HSCT patients are a high-risk group for infection. Usually the causative agent of infection is difficult to determine, and sometimes the site of infection is concealed. This report highlights the importance of suspecting hantavirus infection in allo-HSCT patients with CNS symptoms despite the absence of renal syndromes. The mNGS is a powerful tool for detecting pathogens. CNS infection with Seoul orthohantavirus in transplant patients is rare but possible as demonstrated in this case. To the best of our knowledge, this is the first reported case employing mNGS to diagnose SEOV caused CNS infection in an allo-HSCT patient.

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Section: Discussionmentioning

confidence: 99%

Central nervous system infection with Seoul Orthohantavirus in a child after hematopoietic stem cell transplantation: a case report

Liu

et al. 2022

Virol J

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“…For example, frequent development of ARDS is observed in HFRS caused by DOBV and HTNV [ 186–188 , 211 ]. In PUUV infections, there are case reports that the human lung may be the primarily organ system affected, with PUUV being additionally detected in bronchoalveolar lavage (BAL) fluid [ 168 , 208 , 209 , 212–215 ]. In HCPS-assigned SNV and ANDV, RRT is often needed for acute treatment [ 198 , 203 , 216 ].…”

Section: Introductionmentioning

confidence: 99%

The kidney in hantavirus infection—epidemiology, virology, pathophysiology, clinical presentation, diagnosis and management

Koehler

Cristanziano

Späth

et al. 2022

Clinical Kidney Journal

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Hantavirus-induced diseases are emerging zoonoses with endemic appearances and frequent outbreaks in different parts of the world. In humans, hantaviral pathology is characterized by the disruption of the endothelial cell barrier followed by an increased capillary permeability, thrombocytopenia due to platelet activation/depletion and an overactive immune response. Genetic vulnerability due to certain human leukocyte antigen haplotypes is associated with disease severity. Typically, two different hantavirus-caused clinical syndromes have been reported: haemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). The primarily affected vascular beds differ in these two entities: renal medullary capillaries in HFRS caused by Old-World hantaviruses and pulmonary capillaries in HCPS caused by New-World hantaviruses. Disease severity in HFRS ranges from mild, e.g., Puumala-virus associated nephropathia epidemica, to moderate, e.g., Hantaan- or Dobrava-virus infections. HCPS leads to a severe acute respiratory distress syndrome with high mortality rates. Due to novel insights into organ tropism, hantavirus-associated pathophysiology and overlapping clinical features HFRS and HCPS are believed to be interconnected syndromes frequently involving the kidneys. As there are no specific antiviral treatments or vaccines approved in Europe or the United States, only preventive measures and public awareness may minimize the risk of hantavirus infection. Treatment remains primarily supportive and, depending on disease severity, more invasive measures (e.g., renal replacement therapy, mechanical ventilation and extracorporeal membrane oxygenation) are needed.

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“…Кроме того, ВИЧ-инфекция и применение антиретровирусных препаратов могут приводить к гипертензии и диабету и, как следствие, к гипертензивной и диабетической нефропатии [7,8]. Известно, что риск возникновения хронической почечной патологии увеличивается как при наличии традиционных факторов риска, таких как пожилой возраст, сахарный диабет, ар-териальная гипертензия [9], так и при развитии сопутствующих ВИЧ-инфекции состояний -СПИД, HCV-и HBV-инфекции, а также на фоне приема антиретровирусных препаратов [4,10,11].…”

Section: Introductionunclassified

Features of the course of hemorrhagic fever with renal syndrome in HIV-infected patients

Manakhov

Povysheva

GILYAZOVA

et al. 2020

Russian Journal of Infection and Immunity

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Human immunodeficiency virus (HIV) is a significant medical and social problem for many developed countries. HIV infection is featured with developing chronic kidney pathology as well as acute renal damage. In some regions, hemorrhagic fever with renal syndrome (HFRS) can contribute somehow to developing renal pathology in HIVinfected subjects. The aim of the study was to identify clinical and laboratory features of HFRS course during HIV infection. A retrospective study was conducted by forming two groups: group 1 consisted of 9 patients suffered from HFRS together with verified HIV infection, group 2 — 53 patients with HFRS but lacking any clinical and epidemiological indications supporting HIV infection. Subjects in both groups were age- and sex-matched. The average age of the patients in group 1 and group 2 was 34 and 31 years, respectively. For statistical analysis, the licensed SPSS 22.0 software was used. A significance level p for statistical criteria was set equal to 0.05. In general, HFRS course in all patients was accompanied by characteristic signs: intoxication syndrome, impaired vision, hemorrhagic rash, pain in the lumbar region, decreased diuresis, thrombocytopenia, proteinuria, polymorphic urinary syndrome and azotemia. HFRS patients with concomitant HIV infection often complain of dry mouth, bloating, visible shortness of breath. Laboratory changes describe more severe kidney damage. A direct strong correlation was shown between leukocyte count and level of blood urea in patients with concomitant HIV infection (r = 0.798; p = 0.01). The combination of HFRS and HIV was accompanied by a milder HFRS course — rate of mild disease was almost 6-fold higher among patients of this group. In this case, no cases of severe hemorrhagic fever with renal syndrome combined with HIV were noted. Our study allowed to obtain unambiguous data. Predisposition of HIV-infected patients to renal pathology may be a determining factor in kidney damage upon emerging HFRS: more prominent rise in creatinine and urea level. Moreover, according to rating scale for assessing HFRS severity, it formally turned out that during concomitant HIV infection patients more often fit to a mild disease severity, even in the presence of more pronounced renal manifestations. The occurrence of acute renal pathology in HIV-infected patients is a life-threatening condition, a factor of deterioration of chronic renal pathology and a predictor of death. Consequently, this patient population requires thorough monitoring both at inpatient and outpatient stages.

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Systemische Hantavirus-Infektion bei einem komatösen HIV Patienten

Abstract: In summary the Puumala infection bears the potential for a severe multi-organ failure, which is not typical for this usually benign infection.

Cited by 4 publications

References 20 publications

Central nervous system infection with Seoul Orthohantavirus in a child after hematopoietic stem cell transplantation: a case report

Central nervous system infection with Seoul Orthohantavirus in a child after hematopoietic stem cell transplantation: a case report

The kidney in hantavirus infection—epidemiology, virology, pathophysiology, clinical presentation, diagnosis and management

Features of the course of hemorrhagic fever with renal syndrome in HIV-infected patients

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