Catastrophic presentation of Hantavirus infection in a 12-year-old child: A case report

Abstract

Hanta hemorrhagic fever is a viral zoonotic infection spread through rats, which has rarely been reported in India. It can present in two forms – hanta hemorrhagic renal syndrome and hanta cardiopulmonary syndrome. This case report describes a patient with hantavirus renal syndrome with pulmonary hemorrhage and cardiac dysfunction. A 12-year-old male child presented with fever, vomiting, and hematemesis. He had a complicated course with hypotensive shock, acute kidney injury, and pulmonary hemorrhage. On investigation, the patient had anemia, thrombocytopenia, and acanthocytes on PS. His investigations for dengue, malaria, leptospirosis, and autoimmune disease were negative. There was severe systolic dysfunction with severe mitral regurgitation on two-dimensional echocardiography. Hanta virus immunoglobulin M (IgM) and IgG are significantly positive (>15 units/mL) by enzyme immunoassay. Despite all supportive measures, he succumbed on day 5 of intensive care stay.