Division of Infectious Diseases, Department of Internal Medicine, Patras University General Hospital, Patras, Greece.
Crit Rev Microbiol. 2012 Nov;38(4):317-29. doi: 10.3109/1040841X.2012.673553. Epub 2012 May 3.
Hantaviruses cause Hantavirus Pulmonary Syndrome (HPS; also called Hantavirus Cardiopulmonary Syndrome) in the Americas and Hemorrhagic Fever with Renal Syndrome (HFRS) in Asia and Europe. In Scandinavia and northern Europe, a milder form of HFRS is prevalent, termed nephropathica epidemica (NE). HPS presents with acute respiratory failure, mild-moderate renal failure, thrombocytopenia, and reactive lymphocytosis. HFRS has pronounced renal dysfunction and less prominent respiratory involvement, with thrombocytopenia and hemorrhagic findings. Both syndromes have long-term sequelae. Common symptomatology is due to underlying pathophysiology, mainly increased vascular permeability and immune activation. Laboratory and imaging markers predicting disease severity are under research, allowing for more efficient patient management. Diagnosis is presumptive, based on typical clinical findings and patient history of likely rodent exposure. Confirmation of diagnosis is by serological testing and/or RT-PCR. Treatment is mainly comprised of cardiovascular, respiratory, and renal function support, with fluid and electrolyte homeostasis being crucial components of care. In HPS, the use of extracorporeal membrane oxygenation in decompensated patients has also shown to be beneficial.
汉坦病毒可引起美洲的汉坦病毒肺综合征（HPS；也称为汉坦病毒心肺综合征）和亚洲及欧洲的肾综合征出血热（HFRS）。在斯堪的纳维亚和北欧，流行着一种较轻的 HFRS 形式，称为流行性肾病（NE）。HPS 表现为急性呼吸衰竭、轻度至中度肾功能衰竭、血小板减少和反应性淋巴细胞增多。HFRS 则有明显的肾功能障碍和不太明显的呼吸受累，伴有血小板减少和出血表现。两种综合征都有长期的后遗症。常见的症状是由于潜在的病理生理学原因，主要是血管通透性增加和免疫激活。目前正在研究预测疾病严重程度的实验室和影像学标志物，以实现更有效的患者管理。诊断是基于典型的临床发现和患者可能接触过啮齿动物的病史进行推测。通过血清学检测和/或 RT-PCR 来确认诊断。治疗主要包括心血管、呼吸和肾功能支持，液体和电解质平衡是护理的重要组成部分。在 HPS 中，对失代偿患者使用体外膜氧合也显示出有益的效果。
