Hantavirus cardiopulmonary syndrome

Last reviewed: 6 Sep 2022
Last updated: 18 Feb 2020

Summary

Definition

History and exam

Key diagnostic factors

  • exposure to rodent excreta
  • dyspnea
  • hypotension
More key diagnostic factors

Other diagnostic factors

  • fever
  • myalgias
  • gastrointestinal symptoms
  • headache
  • normal or low oxygen saturation
  • lung rales
Other diagnostic factors

Risk factors

  • exposure to rodent excreta
  • close contact with hantavirus-infected humans
  • male sex
  • white race
More risk factors

Diagnostic investigations

1st investigations to order

  • CBC
  • CXR
  • IgM and IgG serologies for hantavirus
  • reverse transcriptase polymerase chain reaction (RT-PCR)
More 1st investigations to order

Investigations to consider

  • ABG
  • serum lactate
  • ECG
  • echocardiogram
  • flow-directed pulmonary artery catheter (Swan-Ganz catheter)
  • lung biopsy
More investigations to consider

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.

Eileen Farnon, MD

Medical Epidemiologist

Parasitic Diseases Branch

CDC/NCZVED/DPD

Atlanta

GA

Disclosures

EF declares that she has no competing interests.

  • Hantavirus cardiopulmonary syndrome images
  • Differentials

    • Viral upper respiratory tract infection
    • Influenza
    • Mycoplasma pneumoniae pneumonia
    More Differentials
  • Guidelines

    • CDC Health information for international travel (the yellow book): viral hemorrhagic fevers
    • Hantavirus pulmonary syndrome reporting and investigation guideline
    More Guidelines
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