0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:12
656 Hantavirus Pulmonary Syndrome Hartnup’s Disease■IgG/IgM tests excellent (ELISA/ strip immunoblot/Western blot)
almost always positive at time of hospitalization
■PCR/sequencing good for epidemiology, available in research set-
tings
differential diagnosis
n/a
management
■Ribavarin was initially thought to be effective, but no longer.
■Good supportive care
■In severe cases, extracorporeal membrane oxygenation (ECMO)
should be considered.
■Clinical consultation available from the staff at the University of New
Mexico – call 1-888-UNMPALS.
■Some experts believe early transfer to a tertiary care center (partic-
ularly those with experience in treating HPS) is beneficial.
■No person-to-person transmission in the U.S.
specific therapy
n/a
follow-up
n/a
complications and prognosis
Complications
■Mortality rate for patients with cardiopulmonary disease 40–45%
■If patient survives pulmonary capillary leak phase, permanent
sequelae are uncommon.
Prevention
■Prevention is main way to decrease morbidity and mortality.
■Avoid exposure to wild rodents and excreta, especially indoor expo-
sure in closed, poorly ventilated spaces.Hartnup’s Disease....................................
MICHEL BAUM, MD
history & physical
■Pellagra-like skin rash, ataxia and behavioral disturbances
tests
■Niacin deficiency, low plasma levels of neutral amino acids