法属圭亚那由 Maripa 病毒引发的毛细血管渗漏综合征：病例报告及发病机制的启示。
Capillary leak-syndrome triggered by Maripa virus in French Guiana: case report and implication for pathogenesis.
机构信息
Service de Réanimation Polyvalente, Centre Hospitalier Andrée Rosemon de Cayenne, Avenue des Flamboyants, 6006 97306, Cayenne, BP, French Guiana.
Centre National de Référence des Hantavirus, Laboratoire associé, Institut Pasteur de la Guyane, Cayenne, French Guiana.
出版信息
BMC Infect Dis. 2019 Mar 15;19(1):260. doi: 10.1186/s12879-019-3887-5.
BACKGROUND
We report hereby a severe case of Hantavirus Pulmonary Syndrome" (HPS) induced by Maripa virus in French Guiana and describe the mechanism of severity of the human disease.
CASE PRESENTATION
A 47-year- old patient started presenting a prodromic period with fever, dyspnea, cough and head ache. This clinical presentation was followed by a rapid respiratory, hemodynamic and renal failure leading to admission in the ICU. Biological exams revealed an increased haematocrit level with a paradoxical low protein level. Echocardiographic and hemodynamic monitoring showed a normal left ventricular function with low filling pressures, an elevated extravascular lung water index and pulmonary vascular permeability index. These findings were compatible with a capillary leak-syndrome (CLS).
CONCLUSIONS
The severity of HPS caused by the virus Maripa in French Guiana can be explained by the tropism of hantavirus for the microvascular endothelial cell leading to a CLS.
背景
我们报告了法属圭亚那马拉巴病毒引起的严重汉坦病毒肺综合征（HPS）病例，并描述了人类疾病严重程度的机制。
病例介绍
一名 47 岁患者开始出现发热、呼吸困难、咳嗽和头痛的前驱期。随后出现快速呼吸、血流动力学和肾功能衰竭，导致入住 ICU。生物学检查显示血细胞比容水平升高，而蛋白水平反常降低。超声心动图和血流动力学监测显示左心室功能正常，充盈压低，肺血管外水指数和肺血管通透性指数升高。这些发现与毛细血管渗漏综合征（CLS）相符。
结论
法属圭亚那马拉巴病毒引起的 HPS 严重程度可归因于汉坦病毒对微血管内皮细胞的嗜性，导致 CLS。
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