Case history

Case history #1

A 34-year-old otherwise healthy white man is seen in the emergency department. He reports 2 days of fever of up to 103°F (39.5°C), severe myalgias in his legs and back, headache, nausea, and vomiting. He lives in a trailer in a rural area of southwest Colorado and frequently sees mice in and around the trailer. He is a carpenter and has recently been renovating the interiors of some old barns into luxury homes. On exam he is noted to have a fever of 102°F (39°C), blood pressure of 110/76 mmHg, a pulse rate of 96 bpm, a respiratory rate of 24 breaths per minute, and oxygen saturation on room air of 96%. The remainder of his physical exam is normal.

Case history #2

A 54-year-old previously healthy white man from rural New Mexico was admitted to the hospital 36 hours earlier for management of a presumed viral pneumonia. He was empirically started on intravenous antibiotics, and oral oseltamivir pending laboratory results. On exam today he seems more unwell, his blood pressure is 95/60 mmHg, pulse rate is 96 bpm, and respiratory rate is 36 breaths per minute. His oxygen saturation on 4 L/minute nasal oxygen is 90%. He has bilateral diffuse rales on lung exam and a S3 sound on cardiac exam with no murmurs.

Other presentations

​Upper respiratory tract symptoms (e.g., sore throat, nasal congestion, sneezing), are rarely described with hantavirus infection and would tend to exclude the diagnosis.[5]​ Patients may develop dyspnea, chest tightness, and a cough as the lungs fill with fluid during the cardiopulmonary phase of disease.[6]​

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