Journal Article

Hantavirus Pulmonary Syndrome Caused by Puumala Orthohantavirus—A Case Report and Literature Review

Ljubić, Jelena, Kurolt, Ivan Christian, Margeta Marić, Ivana, Zakotnik, Samo, Gjurašin, Branimir, Žunec, Renata, Šoštar, Nikola, Šimičić, Petra, Ribarović, Ana, Bogdanić, Maja, Santini, Marija, Višković, Klaudija, Židovec-Lepej, Snjezana, Krznarić, Juraj, Balent, Nataša Cetinić, Avšič-Županc, Tatjana, Korva, Miša, Kutleša, Marko, Radmanić, Leona, Vilibić-Čavlek, Tatjana

2023

Overview

In this article, we report on a rare case of acute respiratory distress syndrome (ARDS) caused by the Puumala orthohantavirus (PUUV), which is typically associated with hemorrhagic fever with renal syndrome (HFRS). This is the first documented case of PUUV-associated ARDS in Southeast Europe. The diagnosis was confirmed by serum RT-PCR and serology and corroborated by phylogenetic analysis and chemokine profiling. The patient was a 23-year-old male from Zagreb, Croatia, who had recently traveled throughout Europe. He presented with fever, headache, abdominal pain, and sudden onset of ARDS. Treatment involved high-flow nasal cannula oxygen therapy and glucocorticoids, which resulted in a full recovery. A systematic literature review identified 10 cases of hantavirus pulmonary syndrome (HPS) caused by PUUV in various European countries and Turkey between 2002 and 2023. The median age of patients was 53 years (range 24–73), and six of the patients were male. Most patients were treated in intensive care units, but none received antiviral therapy targeting PUUV. Eight patients survived hospitalization. The presented case highlights the importance of considering HPS in the differential diagnosis of ARDS, even in areas where HFRS is the dominant form of hantavirus infection.

• Publisher: MDPI AG
• Subject: Acute respiratory distress syndrome / Antiviral agents / blood serum / Care and treatment / Case reports / case studies / Causes of / chemokine profile / Chemokines / Croatia / Diagnosis / Differential diagnosis / Electrocardiography / Epidemics / Fever / Glucocorticoids / Hantaviridae infections / Hantavirus / Hantavirus pulmonary syndrome / Hantaviruses / Headache / Health aspects / Hemorrhagic fever / Hemorrhagic fever with renal syndrome / Hospitals / immunomodulatory therapy / Infections / Infectious diseases / Intensive care / Intensive care units / Literature reviews / Males / Medical research / Mortality / nose / oxygen / Patients / Phylogeny / Puumala orthohantavirus / Respiratory distress syndrome / Serology / Southern European region / therapeutics / Viruses