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Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection

Year 2012, Volume: 2 Issue: 04, 155 - 159, 01.12.2012
https://doi.org/10.5799/jmid.123129

Abstract

References

  • Jonsson CB, Figueiredo LT, Vapalahti O. A global perspective on hantavirus ecology, epidemiology, and disease. Clin Mi- crobiol Rev 2010; 23:412-441.
  • Song, G. Epidemiological progresses of hemorrhagic fever with renal syndrome in China. Chin Med J (Engl.) 1999; 112:472-477.
  • Heyman P, Vaheri A, Lundkvist A, Avsic-Zupanc T. Hantavirus infections in Europe: from virus carriers to a major public- health problem. Expert Rev Anti Infect Ther 2009; 7:205-217.
  • Heyman P, Vaheri A; ENIVD Members. Situation of hantavi- rus infections and haemorrhagic fever with renal syndrome in European countries as of December 2006. Euro Surveill 2008; 13 (28). pii: 18925.
  • Simpson SQ, Spikes L, Patel S, Faruqi I. Hantavirus pulmo- nary syndrome. Infect Dis Clin North Am 2010; 24:159-173.
  • Muranyi W, Bahr U, Zeier M, van der Woude FJ. Hantavirus infection. J Am Soc Nephrol 2005; 16:3669-3679.
  • Vapalahti O, Mustonen J, Lundkvist A, Henttonen H, Plyusnin A, Vaheri A. Hantavirus infections in Europe. Lancet Infect Dis 2003;3:653-661.
  • Ertek M, Buzgan T; Refik Saydam National Public Health Agency. An outbreak caused by Hantavirus in the Black Sea Region of Turkey, January-May 2009. Euro Surveill 2009; 14(20).
  • Sargianou M, Watson DC, Chra P, et al. Hantavirus infections for the clinician: From case presentation to diagnosis and treatment. Crit Rev Microbiol 2012; 38:317-329.
  • Kaya S, Yılmaz G, Erensoy S, Yağçı ÇD, Uyar Y, Köksal I. Hantavirus infection: two case reports from a province in the Eastern Black Sea Region, Turkey. Mikrobiyol Bul 2010;44:479-487.
  • Maftei ID, Segall L, Gatej RP, Ceianu C, Covic A. Hantavirus infection-Hemorrhagic fever with renal syndrome: the first case series reported in Romania and review of the literature. Int Urol Nephrol 2012; 44:1185-1191.
  • Hukić M, Tulumović D, Calkić L. The renal failure and capil- lary leak during the acute stage of (Dobrava) DOB and PUU (Puumala) infection. Med Arh 2005; 59:227-230.
  • Takeuchi T, Yamamoto T, Itoh M, Tsukada K, Yasue N, Lee HW. Clinical studies on hemorrhagic fever with renal syn- drome found in Nagoya City University Medical School. Kid- ney Int Suppl 1991;35:84-87.
  • Sundberg E, Hultdin J, Nilsson S, Ahlm C. Evidence of dis- seminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness. PLoS One 2011; 6:e21134. Epub 2011 Jun 23.
  • Rasche FM, Uhel B, Krüger DH, et al. Thrombocytopenia and acute renal failure in Puumala hantavirus infections. Emerg- ing Infectious Diseases 2004; 10: 1420-1425.

Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection

Year 2012, Volume: 2 Issue: 04, 155 - 159, 01.12.2012
https://doi.org/10.5799/jmid.123129

Abstract

Objectives: To determine the clinical and laboratory predictors of fatality among patients with Hantavirus infection. Material and methods: A retrospective study was conducted on the patients with Hantavirus infection between April 2009 and October 2011 at the Black Sea and the Mediterranean regions in Turkey. Demographic, clinical and laboratory findings of fatal cases and non-fatal cases at the admission were compared. Results: Twenty-two patients with confirmed Hantavirus infection were evaluated. Five patients died (22.7%). The cause of death was massive bleeding. The rate of hemorrhage was significantly higher in the fatal cases than non-fatal cases (p<0.001). Massive gastrointestinal hemorrhage was seen in four of these patients, cerebral hemorrhage in two and both gastrointestinal and pulmonary hemorrhage in one. Disseminated intravascular coagulation (DIC) was present in four of the fatal cases and a remarkable cause of the bleeding (p=0.02). White blood cell count (WBC) (p=0.002), creatine phosphokinase (CPK) (p=0.011), blood-urea-nitrogen (BUN) (p=0.014), C reactive protein (CRP) (p=0.005) and D-dimer levels (p=0.001), prothrombin time (PT) (p=0.023), activated partial thromboplastin time (aPTT) (p=0.001) and international normalized ratio (INR) (p=0.021) were significantly higher, and platelet counts (p=0.038) significantly lower in the fatal cases. Optimum diagnostic cut-off points for specific laboratory parameters which may be predictive of fatality were; WBC=16,000 &micro;L-1, PLT=30000 &micro;L-1, PT=19.7 s, aPTT=36 s, INR=1.2, D-dimer=9.3 &micro;g/mL, CPK=600 U/L, BUN=47 mg/dL and CRP=13.4 mg/dL. Conclusions: Physicians should be aware of the high fatality risk for patients with Hantavirus infection with hemorrhage, elevated WBC, CPK, BUN, CRP, PT, aPTT, INR and D-dimer and reduced platelet counts.

References

  • Jonsson CB, Figueiredo LT, Vapalahti O. A global perspective on hantavirus ecology, epidemiology, and disease. Clin Mi- crobiol Rev 2010; 23:412-441.
  • Song, G. Epidemiological progresses of hemorrhagic fever with renal syndrome in China. Chin Med J (Engl.) 1999; 112:472-477.
  • Heyman P, Vaheri A, Lundkvist A, Avsic-Zupanc T. Hantavirus infections in Europe: from virus carriers to a major public- health problem. Expert Rev Anti Infect Ther 2009; 7:205-217.
  • Heyman P, Vaheri A; ENIVD Members. Situation of hantavi- rus infections and haemorrhagic fever with renal syndrome in European countries as of December 2006. Euro Surveill 2008; 13 (28). pii: 18925.
  • Simpson SQ, Spikes L, Patel S, Faruqi I. Hantavirus pulmo- nary syndrome. Infect Dis Clin North Am 2010; 24:159-173.
  • Muranyi W, Bahr U, Zeier M, van der Woude FJ. Hantavirus infection. J Am Soc Nephrol 2005; 16:3669-3679.
  • Vapalahti O, Mustonen J, Lundkvist A, Henttonen H, Plyusnin A, Vaheri A. Hantavirus infections in Europe. Lancet Infect Dis 2003;3:653-661.
  • Ertek M, Buzgan T; Refik Saydam National Public Health Agency. An outbreak caused by Hantavirus in the Black Sea Region of Turkey, January-May 2009. Euro Surveill 2009; 14(20).
  • Sargianou M, Watson DC, Chra P, et al. Hantavirus infections for the clinician: From case presentation to diagnosis and treatment. Crit Rev Microbiol 2012; 38:317-329.
  • Kaya S, Yılmaz G, Erensoy S, Yağçı ÇD, Uyar Y, Köksal I. Hantavirus infection: two case reports from a province in the Eastern Black Sea Region, Turkey. Mikrobiyol Bul 2010;44:479-487.
  • Maftei ID, Segall L, Gatej RP, Ceianu C, Covic A. Hantavirus infection-Hemorrhagic fever with renal syndrome: the first case series reported in Romania and review of the literature. Int Urol Nephrol 2012; 44:1185-1191.
  • Hukić M, Tulumović D, Calkić L. The renal failure and capil- lary leak during the acute stage of (Dobrava) DOB and PUU (Puumala) infection. Med Arh 2005; 59:227-230.
  • Takeuchi T, Yamamoto T, Itoh M, Tsukada K, Yasue N, Lee HW. Clinical studies on hemorrhagic fever with renal syn- drome found in Nagoya City University Medical School. Kid- ney Int Suppl 1991;35:84-87.
  • Sundberg E, Hultdin J, Nilsson S, Ahlm C. Evidence of dis- seminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness. PLoS One 2011; 6:e21134. Epub 2011 Jun 23.
  • Rasche FM, Uhel B, Krüger DH, et al. Thrombocytopenia and acute renal failure in Puumala hantavirus infections. Emerg- ing Infectious Diseases 2004; 10: 1420-1425.
There are 15 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ART
Authors

Uğur Kostakoglu This is me

Gürdal Yılmaz This is me

Serkan Volkan This is me

Sevinc Kant Sökel This is me

Selcuk Kaya This is me

Iftihar Köksal This is me

Publication Date December 1, 2012
Published in Issue Year 2012 Volume: 2 Issue: 04

Cite

APA Kostakoglu, U., Yılmaz, G., Volkan, S., Sökel, S. K., et al. (2012). Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection. Journal of Microbiology and Infectious Diseases, 2(04), 155-159. https://doi.org/10.5799/jmid.123129
AMA Kostakoglu U, Yılmaz G, Volkan S, Sökel SK, Kaya S, Köksal I. Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection. J Microbil Infect Dis. December 2012;2(04):155-159. doi:10.5799/jmid.123129
Chicago Kostakoglu, Uğur, Gürdal Yılmaz, Serkan Volkan, Sevinc Kant Sökel, Selcuk Kaya, and Iftihar Köksal. “Evaluation of Clinical and Laboratory Predictors of Fatality in Patients With Hantavirus Infection”. Journal of Microbiology and Infectious Diseases 2, no. 04 (December 2012): 155-59. https://doi.org/10.5799/jmid.123129.
EndNote Kostakoglu U, Yılmaz G, Volkan S, Sökel SK, Kaya S, Köksal I (December 1, 2012) Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection. Journal of Microbiology and Infectious Diseases 2 04 155–159.
IEEE U. Kostakoglu, G. Yılmaz, S. Volkan, S. K. Sökel, S. Kaya, and I. Köksal, “Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection”, J Microbil Infect Dis, vol. 2, no. 04, pp. 155–159, 2012, doi: 10.5799/jmid.123129.
ISNAD Kostakoglu, Uğur et al. “Evaluation of Clinical and Laboratory Predictors of Fatality in Patients With Hantavirus Infection”. Journal of Microbiology and Infectious Diseases 2/04 (December 2012), 155-159. https://doi.org/10.5799/jmid.123129.
JAMA Kostakoglu U, Yılmaz G, Volkan S, Sökel SK, Kaya S, Köksal I. Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection. J Microbil Infect Dis. 2012;2:155–159.
MLA Kostakoglu, Uğur et al. “Evaluation of Clinical and Laboratory Predictors of Fatality in Patients With Hantavirus Infection”. Journal of Microbiology and Infectious Diseases, vol. 2, no. 04, 2012, pp. 155-9, doi:10.5799/jmid.123129.
Vancouver Kostakoglu U, Yılmaz G, Volkan S, Sökel SK, Kaya S, Köksal I. Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection. J Microbil Infect Dis. 2012;2(04):155-9.