INFECTIOUS DISEASESYMPTOMS/EXAM
■ Hantavirus pulmonary syndrome
■ Initial flulike prodrome (3–4 days)
■ Followed by:
■ Pulmonary edema/hypoxia
■ Thrombocytopenia
■ Metabolic acidosis
■ Hypotension
■ Sin Nombre virus (a close relative to Hanta) may also cause Hantavirus
pulmonary syndrome
DIFFERENTIAL
Influenza, bacterial pneumonia, ARDS
DIAGNOSIS
■ History of exposure and clinical diagnosis
■ Confirmed by immunofluorescent or immunoblot assays
TREATMENT
Supportive care (mortality 50–70%)
West Nile Virus
■ Vector: mosquitoes
■ RNA virus
■ Seasonal epidemics (summer and fall)
SYMPTOMS/EXAM
■ Incubation: 3–14 days
■ Most (>70%) who are infected are asymptomatic.
■ Symptoms usually last for 3–6 days.
■ West Nile fever
■ Fever and flulike illness
■ URI symptoms
■ Maculopapular rash (50%)
■ Meningoencephalitis (1 in 150), which can result in acute asymmetric
flaccid paralysis, and bowel or bladder dysfunction, but no sensory
abnormalities
DIAGNOSIS
■ CSF=viral meningoencephalitis.
■ ↑lymphs,↑protein, nl glucose
■ Definitive: Viral isolation or serology (IgM antibody) in CSF or serum
TREATMENT
Supportive
COMPLICATIONS
■ Older patients are primarily at risk for encephalitis/death. Immunocompro-
mised and diabetics also at risk.
■ Hospitalized patients with WNV have a mortality rate of 4–18%.