Hemorrhagic Fever with Renal Failure Syndrome
Hemorrhagic fever with renal failure syndrome (HFRS) is a group of clinically similar illnesses found throughout the world. It is caused by a hantavirus, which is transmitted through aerosolized urine, droppings, saliva, or dust from the nests of infected rodents. Transmission from person to person is rare. HFRS is characterized by fever and renal failure associated with hemorrhagic manifestations. The severity of the virus is related to the specific type of viral infection. HFRS occurs more often in males and in people older than age 15.
Causes
HFRS is caused by hantaviruses from the Bunyaviridae family, specifically Hantaan virus, which is widely distributed in Asia; Dobrava virus, found in the Balkans; Puumala virus, found in Scandinavia, Western Europe, and Russia; and Seoul virus, which occurs worldwide and has been found in many cities in the eastern part of the United States.
Complications
Complications of HFRS include retroperitoneal bleeding, intraventricular bleeding, renal rupture, pulmonary edema, neurologic and renal tubular defects, hepatomegaly and liver dysfunction, chronic renal insufficiency, and hypertension from renal disease. Hypovolemic shock may result from severe fluid loss. Hypopituitarism may occur but is usually temporary. The Dobrava virus causes a severe form of HFRS and may result in death.
Assessment Findings
Signs and symptoms of HFRS appear 2 to 8 weeks after infection. There are five stages to the illness: febrile, hypotensive, oliguric, diuretic, and convalescent:
The initial febrile stage includes high fevers (up to 104° F [40° C]). Other signs include the following, which occur suddenly and last 4 to 6 days: chills, blurred vision, subconjunctival hemorrhage, back and abdominal pain, and headache. Flushing of the face, neck, and chest may be present.
The hypotensive stage includes tachycardia, hypotension, and possibly convulsions and lasts a few hours to 2 days. Paralytic ileus may occur, causing an acute abdomen.
The oliguric stage lasts 3 to 6 days and includes oliguria, hypertension, edema, and bleeding tendencies. During this phase, thrombocytopenia may resolve.Related posts:
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