Diagnostic and Clinical Challenges of Hantavirus-Associated Acute Kidney Injury - PubMed

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Hantavirus infection is an uncommon zoonosis in Europe, often presenting with acute kidney injury.
The disease typically manifests with renal involvement, though pulmonary symptoms can mimic pulmonary-renal syndromes, complicating diagnosis.
A case study describes a 46-year-old man with acute febrile illness, severe thrombocytopenia, acute kidney injury, proteinuria, and microscopic haematuria.
Imaging showed bilateral pulmonary abnormalities, suggesting an acute pulmonary-renal syndrome; autoimmunity and other infections were excluded.
Diagnosis was confirmed via positive IgM and IgG serology for Hantavirus, with molecular identification of Puumala virus.
Renal biopsy revealed moderate acute tubular necrosis with minimal inflammation and preserved glomeruli.
Supportive care led to rapid clinical improvement and complete recovery of renal function, highlighting the self-limited nature of Puumala virus infection.
Early diagnosis is crucial to avoid unnecessary immunosuppressive therapy and ensure excellent renal prognosis.
Key diagnostic clues include thrombocytopenia, acute pulmonary-renal involvement, and epidemiological exposure to rural or rodent environments.

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