斯里兰卡汉坦病毒感染的非典型病例：一例报告。
Atypical case of hantavirus infection in Sri Lanka mimicking leptospirosis: a case report.
机构信息
Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
University Medical Unit, Teaching Hospital, Peradeniya, Sri Lanka.
出版信息
J Med Case Rep. 2020 Jun 18;14(1):71. doi: 10.1186/s13256-020-02417-6.
BACKGROUND
Hantavirus infection is an emerging zoonotic infection which has two characteristic patterns of presentation: hantavirus pulmonary syndrome and hemorrhagic fever with renal syndrome. The clinical presentation of hantavirus infection closely mimics leptospirosis.
CASE PRESENTATION
This case report describes a previously apparently well 36-year-old Sri Lankan Sinhalese man who presented with an acute febrile illness with myalgia, with liver involvement in the form of transaminitis, cardiac involvement in the form of myocarditis, acute kidney injury, and pulmonary involvement. He was initially managed as severe leptospirosis with multiorgan dysfunction with antibiotics, steroids, and N-acetyl cysteine. A diagnosis of acute hantavirus infection was made subsequently. He made an uneventful recovery.
CONCLUSION
Hantavirus infections need to considered in the differential diagnosis of patients presenting with acute febrile illness with multiorgan involvement. Larger studies are needed to evaluate the seroprevalence of hantavirus in Sri Lanka because it could be an emerging serious public health problem.
背景
汉坦病毒感染是一种新兴的人畜共患传染病，有两种特征性的表现形式：汉坦病毒肺综合征和肾综合征出血热。汉坦病毒感染的临床表现与钩端螺旋体病非常相似。
病例介绍
本病例报告描述了一位之前看似健康的 36 岁斯里兰卡僧伽罗人，他出现急性发热伴肌痛，肝功能异常表现为转氨酶升高，心肌受累表现为心肌炎，急性肾损伤和肺部受累。他最初被诊断为严重钩端螺旋体病，合并多器官功能障碍，接受了抗生素、类固醇和 N-乙酰半胱氨酸治疗。随后诊断为急性汉坦病毒感染。他恢复顺利。
结论
在急性发热伴多器官受累的患者的鉴别诊断中需要考虑汉坦病毒感染。需要进行更大规模的研究来评估汉坦病毒在斯里兰卡的血清流行率，因为它可能成为一个新的严重公共卫生问题。
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