Hantavirus infection natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
*Within 24 hours of initial evaluation, most patients develop some degree of [[hypotension]] and progressive evidence of [[pulmonary edema]] and [[hypoxia]], usually requiring mechanical ventilation. The patients with fatal infections appear to have severe myocardial depression which can progress to [[sinus bradycardia]] with subsequent [[electromechanical dissociation]], [[ventricular tachycardia]] or [[fibrillation]]. | *Within 24 hours of initial evaluation, most patients develop some degree of [[hypotension]] and progressive evidence of [[pulmonary edema]] and [[hypoxia]], usually requiring mechanical ventilation. | ||
*The patients with fatal infections appear to have severe myocardial depression which can progress to [[sinus bradycardia]] with subsequent [[electromechanical dissociation]], [[ventricular tachycardia]] or [[fibrillation]]. | |||
*Hemodynamic compromise occurs a median of 5 days after symptom onset--usually dramatically within the first day of hospitalization. | |||
*In contrast to HFRS, overt hemorrhage occurs rarely in HPS, although hemorrhage is occasionally seen in association with disseminated intravascular coagulation. | |||
*In contrast to septic shock, HPS patients have a low cardiac output with a raised systemic vascular resistance. Poor prognostic indicators include a plasma lactate of greater than 4.0 mmol/L or a cardiac index of less than 2.2 L/min/m2 Whilst pulmonary edema and pleural effusions are common, [[multiorgan dysfunction syndrome]] is rarely seen. *However, HPS patients sometimes have mildly impaired renal function. Survivors frequently become polyuric during convalescence and improve almost as rapidly as they decompensated. | |||
==Complications== | |||
Complications that can develop as a result of Hantavirus infection depends on the type of infection which include | |||
* Acute encephalomyelitis | |||
* Bleeding | |||
* Multiorgan dysfunction | |||
* Pituitary hemorrhage | |||
* Glomerulonephritis | |||
* Pulmonary edema | |||
* Acute respiratory distress syndrome | |||
* Disseminated intravascular coagulation | |||
* renal insufficiency, | |||
* Thrombocytopenia | |||
* Bleeding | |||
* Myalgia | |||
* Vomiting | |||
* Diarrhea | |||
* Shock | |||
lethal outcome | |||
==References== | ==References== | ||
Revision as of 17:16, 7 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Natural History
- Within 24 hours of initial evaluation, most patients develop some degree of hypotension and progressive evidence of pulmonary edema and hypoxia, usually requiring mechanical ventilation.
- The patients with fatal infections appear to have severe myocardial depression which can progress to sinus bradycardia with subsequent electromechanical dissociation, ventricular tachycardia or fibrillation.
- Hemodynamic compromise occurs a median of 5 days after symptom onset--usually dramatically within the first day of hospitalization.
- In contrast to HFRS, overt hemorrhage occurs rarely in HPS, although hemorrhage is occasionally seen in association with disseminated intravascular coagulation.
- In contrast to septic shock, HPS patients have a low cardiac output with a raised systemic vascular resistance. Poor prognostic indicators include a plasma lactate of greater than 4.0 mmol/L or a cardiac index of less than 2.2 L/min/m2 Whilst pulmonary edema and pleural effusions are common, multiorgan dysfunction syndrome is rarely seen. *However, HPS patients sometimes have mildly impaired renal function. Survivors frequently become polyuric during convalescence and improve almost as rapidly as they decompensated.
Complications
Complications that can develop as a result of Hantavirus infection depends on the type of infection which include
- Acute encephalomyelitis
- Bleeding
- Multiorgan dysfunction
- Pituitary hemorrhage
- Glomerulonephritis
- Pulmonary edema
- Acute respiratory distress syndrome
- Disseminated intravascular coagulation
- renal insufficiency,
- Thrombocytopenia
- Bleeding
- Myalgia
- Vomiting
- Diarrhea
- Shock
lethal outcome