Resumo
Definition
History and exam
Key diagnostic factors
- exposição a fezes/mordida de roedores
- dispneia
- hipotensão
Other diagnostic factors
- febre
- mialgias
- sintomas gastrointestinais
- cefaleia
- saturação de oxigênio normal ou baixa
- estertores pulmonares
Risk factors
- exposição a fezes/mordida de roedores
- contato próximo com humanos infectados por hantavírus
Diagnostic investigations
1st investigations to order
- Hemograma completo
- radiografia torácica
- sorologias IgM (imunoglobulina M) e IgG (imunoglobulina G) para hantavírus
- reação em cadeia da polimerase via transcriptase reversa (RT-PCR)
Investigations to consider
- gasometria arterial
- lactato sérico
- eletrocardiograma (ECG)
- ecocardiograma
- cateter arterial pulmonar na direção do fluxo (cateter Swan-Ganz)
- biópsia pulmonar
Emerging tests
- carga sérica do ácido ribonucleico (RNA) viral
- anticorpos neutralizantes
Treatment algorithm
sepse de causa desconhecida
infecção por hantavírus confirmada
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
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.
Differentials
- Infecção viral do trato respiratório superior
- Gripe (influenza)
- Pneumonia por Mycoplasma pneumoniae
More DifferentialsGuidelines
- CDC Yellow Book: health information for international travel - viral hemorrhagic fevers
More Guidelines
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