Hantavirus Pulmonary Syndrome Follow-up

  • Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD   more...
 
Updated: Jun 21, 2011
 

Further Inpatient Care

  • Admit patients with severe cardiopulmonary compromise to the intensive care unit.
  • Provide respiratory support as needed.
  • The use of vasopressors and the judicious administration of intravenous fluids constitute the mainstays of therapy.
  • Pay careful attention to systemic acidosis and electrolyte abnormalities.
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Further Outpatient Care

  • Continue monitoring patients with mild Hantavirus pulmonary syndrome (HPS) in an outpatient setting until they are completely well.
  • Patients with mild HPS often complain of substernal discomfort. In patients with such symptoms, perform an ECG and/or cardiac enzyme test to help exclude myocardial infarction. Substernal discomfort that is oppressive in character is common in patients recovering from HPS. Although a cardiac explanation for the chest pain is suggested by its sternal location, myocardial infarction is not a complication of HPS.
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Deterrence/Prevention

  • Caution patients against having contact with rodents or aerosolized rodent urine or excreta.
  • Dead rodents should not be handled without taking proper precautions and wearing protection.
  • Make dwellings rodent-proof; follow cleanliness and maintenance procedures such that dwellings do not attract small rodents.
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Complications

  • Renal failure due to ATN may occur.
  • Severe capillary pulmonary leakage may result in intractable noncardiogenic pulmonary edema and cardiorespiratory collapse and/or shock.
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Prognosis

  • The prognosis is excellent for mild cases of HPS.
  • Patients who recover from near-fatal HPS have no residual cardiopulmonary sequelae.
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Patient Education

  • Caution patients to avoid contact with rodents or aerosolized rodent urine or excreta.
  • Do not handle dead rodents without taking proper precautionary and protective measures.
  • Make dwellings rodent-proof.
  • Maintain dwellings in such a manner as to avoid attracting small rodents.
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Contributor Information and Disclosures
Author

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Kenneth C Earhart, MD  Deputy Head, Disease Surveillance Program, United States Naval Medical Research Unit #3

Kenneth C Earhart, MD is a member of the following medical societies: American College of Physicians, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and Undersea and Hyperbaric Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

John L Brusch, MD, FACP  Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD  Professor, Stewart G Wolf Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Association of Professors of Medicine, Association of Program Directors in Internal Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

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