Hemorrhagic Fevers with Renal Syndrome Presenting with Pregnancy Interruption

Hemorrhagic fever with renal syndrome is presented with so many different clinical symptoms. It can present mild form of the disease or the severe symptoms. We reported two cases with HFRS, at pregnant women, ended with pregnancy interruption. Both of them had nearly the same age, both 16 weeks pregnant. They presented with fever, malaise, muscle pain and headache. They were febrile when presented at the hospital, hypotensive, hyperemia on the face. They complained about oligo-anuria too. One of them continued to be hypotension, despite the supportive therapy she had an abortion after 8 hours. The other patient had the abortion on the 4th day of hospitalization. The diagnose was set based on the clinical, epidemiological findings and the serological positive confirmation for IgM Hantavirus by enzyme-linked immunosorbent assay and immunofluorescence assay IFA. The abortion is a rare complication of HFRS in pregnancy. The symptoms are not specific. Early diagnosis and appropriate management are necessary to improve the maternal and fetal outcome. J Microbiol Infect Dis 2017; 7(4):198-201

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  • 1. Berk H, Öztoprak N. Hemorrhagic fever with renal syndrome (Hantaviruses). J Microbiol Infect Dis 2014, 4(5). 2. Županc TA, Korva M, Markotić A. HFRS and hantaviruses in the Balkans/South-East Europe. Virus Research 2014, 187:27-33. 3. Kostakoglu U, Yılmaz G, Volkan S, Sökel SK, Kaya S, Köksal I. Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection. J Microbiol Infect Dis 2012, 2(04). 4. Puca E, Pilaca A, Pipero P, et al. A short review of hemorrhagic fever with renal syndrome and it's extrarenal complications. J Microbiol Infect Dis 2014, 4(5). 5. Emmerich P, Müller N, Heinemann P, et al Human Dobrava-Belgrade hantavirus infection, Kosovo. J Clin Virol 2014, 61(3):439-441. 6. Mustonen J, Vaheri A, Clement J. Third international conference on haemorrhagic fever with renal syndrome (HFRS) and hantaviruses. Nephrology Dialysis Transplantation 1996, 11(4):730-733. 7. Kim B-N, Choi B-D. Hemorrhagic fever with renal syndrome complicated with pregnancy: a case report. The Korean journal of internal medicine 2006, 21(2):150. 8. Hofmann J, Führer A, Bolz M, et al. Hantavirus infections by Puumala or Dobrava-Belgrade virus in pregnant women. Journal of Clinical Virology 2012, 55(3):266-269. 9. Howard MJ, Doyle TJ, Koster FT, et al. Hantavirus pulmonary syndrome in pregnancy. Clin Infect Dis 1999, 29(6):1538-1544. 10. Rogozi E, Bego F, Papa A, Mersini K, Bino S. Distribution and ecology of small mammals in Albania. International journal of environmental health research 2013, 23(3):258-268. 11. Puca E, Pilaca A, Pipero P, et al. Hemorrhagic fever with renal syndrome complicated by orchitis. Virologica Sinica 2011, 26(4):285. 12. Du H, Li J, Yu H-T, et al. Early indicators of severity and construction of a risk model for prognosis based upon laboratory parameters in patients with hemorrhagic fever with renal syndrome. Clinical Chemistry and Laboratory Medicine (CCLM) 2014, 52(11):1667-1675. 13. Ozturk B, Tutuncu E, Kuscu F, Gurbuz Y, Sencan I, Tuzun H. Evaluation of factors predictive of the prognosis in Crimean-Congo hemorrhagic fever: new suggestions. Int J Infect Dis 2012, 16(2):e89-e93.