Hantavirus pulmonary syndrome is a febrile illness characterized by bilateral interstitial pulmonary infiltrates and respiratory compromise resembling adult respiratory distress syndrome. There is typically a prodrome of fever, chills, myalgias, headache, and gastrointestinal distress. Common laboratory findings include one or more of the following: hemoconcentration, left shift in white blood cell count, neutrophilic leukocytosis, thrombocytopenia, or circulating immunoblasts.
Hantavirus should be considered in the setting of one or more of the following: (1) febrile illness [temperature greater than 38.3°C (101°F)] in a previously healthy individual with bilateral interstitial edema that may radiographically resemble adult respiratory distress syndrome and respiratory compromise requiring oxygen support developing within 72 h of hospitalization, or (2) unexplained respiratory illness resulting in death and autopsy examination demonstrating noncardiogenic pulmonary edema without identifiable cause.
Detection of hantavirus-specific IgM or rising titers of IgG, detection of hantavirus-specific ribonucleic acid sequences by polymerase chain reaction techniques in clinical specimens, and detection of hantavirus antigen by immunohistochemistry are all acceptable laboratory methods for confirming the diagnosis.
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