Hantavirus - Revision history

Mholtz at 07:24, 4 November 2018

2018-11-04T07:24:46Z

← Older revision		Revision as of 07:24, 4 November 2018
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	*Thrombocytopenia results in petechiae, ocular bleeding		*Thrombocytopenia results in petechiae, ocular bleeding

	===Hantavirus Pulmonary Syndrome (HPS)===		===Hantavirus Pulmonary Syndrome (HPS)<ref>Hjelle B, et al. Hanta cardiopulmonary syndrome. UpToDate. Waltham, Mass.: UpToDate; 2017. www.uptodate.com. Accessed April 9, 2017.</ref>===
	*Develops several days later, including shortness of breath and cough which rapidly progresses to noncardiogenic pulmonary edema and respiratory failure over 24-48 hours		*Develops several days later, including shortness of breath and cough which rapidly progresses to noncardiogenic pulmonary edema and respiratory failure over 24-48 hours
	*Hemodynamical instability may ensue in the late phase		*Hemodynamical instability may ensue in the late phase
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	==Disposition==		==Disposition==
			*Admit

	==See Also==		==See Also==


			==External Links==
			*https://www.cdc.gov/hantavirus/index.html
			*http://www.cdph.ca.gov/HealthInfo/discond/Documents/HANTAGuidanceForClinicians9-12.pdf [http://www.cdph.ca.gov/HealthInfo/discond/Documents/HANTAGuidanceForClinicians9-12.pdf]

	==References==		==References==
	<references/>		<references/>
	~~These are abbreviated public health recommendations. Please see the full state guidance document at [http://www.cdph.ca.gov/HealthInfo/discond/Documents/HANTAGuidanceForClinicians9-12.pdf]~~

	*https://www.cdc.gov/hantavirus/index.html
	*Hjelle B, et al. Hanta cardiopulmonary syndrome. UpToDate. Waltham, Mass.: UpToDate; 2017. www.uptodate.com. Accessed April 9, 2017.
	[[Category:ID]]		[[Category:ID]]

Kxl328: /* Clinical Features */

2018-11-01T06:07:36Z

Clinical Features

← Older revision		Revision as of 06:07, 1 November 2018
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	*Early symptoms are nonspecific and includes [[fever]], fatigue, myalgia, and [[headache]]		*Early symptoms are nonspecific and includes [[fever]], fatigue, myalgia, and [[headache]]
	*May also exhibit [[abdominal pain]], [[nausea]], [[vomiting]], and [[diarrhea]]		*May also exhibit [[abdominal pain]], [[nausea]], [[vomiting]], and [[diarrhea]]
			*Thrombocytopenia results in petechiae, ocular bleeding

	===Hantavirus Pulmonary Syndrome (HPS)===		===Hantavirus Pulmonary Syndrome (HPS)===

Mholtz: Text replacement - "==Treatment==" to "==Management=="

2017-12-08T20:17:29Z

Text replacement - "==Treatment==" to "==Management=="

← Older revision		Revision as of 20:17, 8 December 2017
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	Call 213-240-7941 (business hours) or 213-974-1234 (after hours) to speak to the duty physician.		Call 213-240-7941 (business hours) or 213-974-1234 (after hours) to speak to the duty physician.

	==~~Treatment~~==		==Management==
	*Supportive care is the main form of treatment		*Supportive care is the main form of treatment
	*Aggressive respiratory support including early intubation and mechanical ventilation for HPS		*Aggressive respiratory support including early intubation and mechanical ventilation for HPS

Mholtz: Text replacement - "* " to "*"

2017-07-14T21:09:43Z

Text replacement - "* " to "*"

Rossdonaldson1 at 21:33, 25 April 2017

2017-04-25T21:33:38Z

Rossdonaldson1: /* Clinical Features */

2017-04-25T21:29:56Z

Clinical Features

← Older revision		Revision as of 21:29, 25 April 2017
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	==Clinical Features==		==Clinical Features==
	* Incubation of 1-8 weeks after exposure to source		* Incubation of 1-8 weeks after exposure to source
	* Early symptoms are nonspecific and includes fever, fatigue, myalgia, and headache		* Early symptoms are nonspecific and includes [[fever]], fatigue, myalgia, and [[headache]]
	* May also exhibit abdominal pain, nausea, vomiting, and diarrhea		* May also exhibit [[abdominal pain]], [[nausea]], [[vomiting]], and [[diarrhea]]
	* ~~HPS develops~~ several days later including shortness of breath and cough which rapidly progresses to noncardiogenic pulmonary edema and respiratory failure over 24-48 hours
			===Hantavirus Pulmonary Syndrome (HPS)===
			* Develops several days later, including shortness of breath and cough which rapidly progresses to noncardiogenic pulmonary edema and respiratory failure over 24-48 hours
	* Hemodynamical instability may ensue in the late phase		* Hemodynamical instability may ensue in the late phase
	* Symptoms that make HPS less likely includes conjunctival injection, petechiae, or rashes		* Symptoms that make HPS less likely includes conjunctival injection, petechiae, or rashes

Rossdonaldson1: /* Differential Diagnosis */

2017-04-19T22:13:15Z

Differential Diagnosis

← Older revision		Revision as of 22:13, 19 April 2017
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	==Differential Diagnosis==		==Differential Diagnosis==
			*Wegener's granulomatosis
			*Goodpasture's syndrome

	{{Lower respiratory zoonotic infections}}		{{Lower respiratory zoonotic infections}}

TJYE: /* Treatment */

2017-04-10T01:47:45Z

Treatment

← Older revision		Revision as of 01:47, 10 April 2017
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	==Treatment==		==Treatment==
	*Supportive care is the main form of ~~treatmetn~~		*Supportive care is the main form of treatment
	*Aggressive respiratory support including early intubation and mechanical ventilation for HPS		*Aggressive respiratory support including early intubation and mechanical ventilation for HPS
	*Hemodynamic support with early vasopressor administration		*Hemodynamic support with early vasopressor administration

TJYE: /* LA County Guidelines (for Yosemite outbreak) */

2017-04-10T01:47:01Z

LA County Guidelines (for Yosemite outbreak)

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 ==Differential Diagnosis==
 {{Lower respiratory zoonotic infections}}
 ==LA County Guidelines (for Yosemite outbreak)==

TJYE: /* Background */

2017-04-10T01:42:37Z

Background

← Older revision		Revision as of 01:42, 10 April 2017
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	* Infection by the Sin Nombre virus can range from a nonspecific viral syndrome to the Hanta Pulmonary Syndrome (HPS), which is a severe respiratory manifestation with a high mortality rate		* Infection by the Sin Nombre virus can range from a nonspecific viral syndrome to the Hanta Pulmonary Syndrome (HPS), which is a severe respiratory manifestation with a high mortality rate
	* Virus is transmitted by rodent urine, droppings, and saliva		* Virus is transmitted by rodent urine, droppings, and saliva
	* ~~Resevoir~~ includes deer mouse, white footed mouse, and cotton rat		* North American resevoir includes deer mouse, white footed mouse, and cotton rat
	* Most cases of exposure US have occurred in southwest states		* Most cases of exposure US have occurred in southwest states

← Older revision		Revision as of 21:09, 14 July 2017
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	==Background==		==Background==
	* Infection by the Sin Nombre virus can range from a nonspecific viral syndrome to the Hanta Pulmonary Syndrome (HPS), which is a severe respiratory manifestation with a high mortality rate		*Infection by the Sin Nombre virus can range from a nonspecific viral syndrome to the Hanta Pulmonary Syndrome (HPS), which is a severe respiratory manifestation with a high mortality rate
	* Virus is transmitted by rodent urine, droppings, and saliva		*Virus is transmitted by rodent urine, droppings, and saliva
	* North American resevoir includes deer mouse, white footed mouse, and cotton rat		*North American resevoir includes deer mouse, white footed mouse, and cotton rat
	* Most cases of exposure US have occurred in southwest states		*Most cases of exposure US have occurred in southwest states

	==Clinical Features==		==Clinical Features==
	* Incubation of 1-8 weeks after exposure to source		*Incubation of 1-8 weeks after exposure to source
	* Early symptoms are nonspecific and includes [[fever]], fatigue, myalgia, and [[headache]]		*Early symptoms are nonspecific and includes [[fever]], fatigue, myalgia, and [[headache]]
	* May also exhibit [[abdominal pain]], [[nausea]], [[vomiting]], and [[diarrhea]]		*May also exhibit [[abdominal pain]], [[nausea]], [[vomiting]], and [[diarrhea]]

	===Hantavirus Pulmonary Syndrome (HPS)===		===Hantavirus Pulmonary Syndrome (HPS)===
	* Develops several days later, including shortness of breath and cough which rapidly progresses to noncardiogenic pulmonary edema and respiratory failure over 24-48 hours		*Develops several days later, including shortness of breath and cough which rapidly progresses to noncardiogenic pulmonary edema and respiratory failure over 24-48 hours
	* Hemodynamical instability may ensue in the late phase		*Hemodynamical instability may ensue in the late phase
	* Symptoms that make HPS less likely includes conjunctival injection, petechiae, or rashes		*Symptoms that make HPS less likely includes conjunctival injection, petechiae, or rashes

	==Differential Diagnosis==		==Differential Diagnosis==

← Older revision		Revision as of 21:33, 25 April 2017
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	{{Lower respiratory zoonotic infections}}		{{Lower respiratory zoonotic infections}}

	==~~Diagnosis~~==		==Evaluation==
	*Serologic test using ELISA assays are the gold standard used by the CDC		*Serologic test using ELISA assays are the gold standard used by the CDC
	*Most patients have antiviral IgM when symptoms are present, IgG may also be positive later on		*Most patients have antiviral IgM when symptoms are present, IgG may also be positive later on

	==Labs and Imaging==		===Labs and Imaging===
	*Earliest lab abnormalities includes a decline in platelet count		*Earliest lab abnormalities includes a decline in platelet count
	*May also see an elevation in LDH, LFTs, and lactate later		*May also see an elevation in LDH, LFTs, and lactate later
	*In HPS, the chest x ray shows diffuse bilateral interstitial edema that may resemble ARDS		*In HPS, the chest x-ray shows diffuse bilateral interstitial edema that may resemble [[ARDS]]
	*~~Decrese~~ in albumin along with increases in H/H marks is a markeer of capillary leak in HPS		*Decrease in albumin along with increases in H/H marks is a markeer of capillary leak in HPS
	*The diagnostic triad in HPS includes thrombocytopenia, left shifted granulocytes, and immunoblast >10% of total lympoid series		*The diagnostic triad in HPS includes thrombocytopenia, left shifted granulocytes, and immunoblast >10% of total lympoid series

	==LA County Guidelines (for Yosemite outbreak)==		===LA County Guidelines (for Yosemite outbreak)===
	Physicians with Patients Presenting with Concerns or Symptoms of Hantavirus Pulmonary Syndrome (HPS) after Visit to Yosemite National Park, June through August 2012.		Physicians with Patients Presenting with Concerns or Symptoms of Hantavirus Pulmonary Syndrome (HPS) after Visit to Yosemite National Park, June through August 2012.

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	*Hemodynamic support with early vasopressor administration		*Hemodynamic support with early vasopressor administration
	*Consider ECMO for refractory cases		*Consider ECMO for refractory cases

			==Disposition==

			==See Also==

	==References==		==References==