Last reviewed: 30 Aug 2023
Last updated: 20 Jun 2023
Summary
Definition
History and exam
Key diagnostic factors
- exposure to rodent excreta/bite
- 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/bite
- close contact with hantavirus-infected humans
More risk factors
Diagnostic investigations
1st investigations to order
- CBC
- chest x-ray
- 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

Professor of Medicine
College of Medicine
University of Florida
Jacksonville
FL
Disclosures
MS declares that he has no competing interests.
Carmen Isache, MD

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.
Differentials
- Viral upper respiratory tract infection
- Influenza
- Mycoplasma pneumoniae pneumonia
More DifferentialsGuidelines
- CDC Yellow Book: health information for international travel - viral hemorrhagic fevers
- Hantavirus reporting and surveillance guidelines
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