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Hantavirus cardiopulmonary syndrome

Last reviewed: 6 Apr 2025
Last updated: 20 Jun 2023

Summary

Definition

History and exam

Key diagnostic factors

  • exposure to rodent excreta/bite
  • dyspnea
  • hypotension
Full details

Other diagnostic factors

  • fever
  • myalgias
  • gastrointestinal symptoms
  • headache
  • normal or low oxygen saturation
  • lung rales
Full details

Risk factors

  • exposure to rodent excreta/bite
  • close contact with hantavirus-infected humans
Full details

Diagnostic tests

1st tests to order

  • CBC
  • chest x-ray
  • IgM and IgG serologies for hantavirus
  • reverse transcriptase polymerase chain reaction (RT-PCR)
Full details

Tests to consider

  • ABG
  • serum lactate
  • ECG
  • echocardiogram
  • flow-directed pulmonary artery catheter (Swan-Ganz catheter)
  • lung biopsy
Full details

Emerging tests

  • serum viral-RNA load
  • neutralizing antibody

Treatment algorithm

INITIAL

sepsis of unknown cause

ACUTE

confirmed hantavirus infection

Contributors

Authors

Michael Sands, MD, MPH &TM, FIDSA
Michael Sands

Professor of Medicine

College of Medicine

University of Florida

Jacksonville

FL

Disclosures

MS declares that he has no competing interests.

Carmen Isache, MD
Carmen Isache

Assistant Professor of Medicine

College of Medicine

University of Florida

Jacksonville

FL

Disclosures

CI declares that she has no competing interests.

Peer reviewers

Tze Wai Wong, FFPH, FRCP (Glasg)

Professor

School of Public Health and Primary Care

The Chinese University of Hong Kong

Prince of Wales Hospital

Shatin

Hong Kong

Disclosures

TWW declares that he has no competing interests.

Mary Joung Won Choi, MD, MPH

Medical Officer

Viral Special Pathogens Branch

US Centers for Disease Control and Prevention

Atlanta

GA

Disclosures

MC declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Jonsson CB, Hooper J, Mertz G. Treatment of hantavirus pulmonary syndrome. Antiviral Res. 2008 Apr;78(1):162-9.Full text  Abstract

Mertz GJ, Hjelle B, Crowley M, et al. Diagnosis and treatment of new world hantavirus infections. Curr Opin Infect Dis. 2006 Oct;19(5):437-42. Abstract

Chang B, Crowley M, Campen M, et al. Hantavirus cardiopulmonary syndrome. Semin Respir Crit Care Med. 2007 Apr;28(2):193-200. Abstract

Centers for Disease Control and Prevention. Hantavirus pulmonary syndrome (HPS) 2015 case definition. 2015 [internet publication].Full text

Centers for Disease Control and Prevention. General hantavirus technical/clinical information: clinical manifestation. August 2012 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • Guidelines

    • CDC Yellow Book: health information for international travel - viral hemorrhagic fevers
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