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Gastroenterology19 papers

South American hemorrhagic fever

Last edited: 4/15/2026

Overview

South American hemorrhagic fever (SAHF) is a severe viral hemorrhagic fever caused by arenaviruses, primarily affecting regions in South America. It includes diseases like Argentine hemorrhagic fever (AHF) and Bolivian hemorrhagic fever (BHF), characterized by fever, hemorrhage, and multi-organ dysfunction 1.

Diagnosis

  • Clinical presentation includes fever, myalgia, headache, and hemorrhagic manifestations 1.
  • Laboratory diagnosis involves detecting viral RNA by RT-PCR in blood or other body fluids 1.
  • Serological tests (IgM and IgG antibodies) are useful but may not be immediately positive in early stages 1.
  • Hematological abnormalities such as thrombocytopenia and leukopenia are common indicators 1.

    • Management

  • First-line treatment: Ribavirin is the mainstay of therapy, administered intravenously at a dose of 5 grams every 6 hours for 4 days (or longer if clinically indicated) 1.
  • Adjunctive care: Supportive measures including fluid resuscitation, blood transfusions, and management of shock are crucial 1.
  • Monitoring: Close monitoring of vital signs, coagulation parameters, and organ function is essential 1.

    • Special Populations

  • Pregnancy: Limited data; ribavirin use in pregnancy requires careful risk-benefit assessment due to potential teratogenic effects 1.
  • Pediatrics: Ribavirin dosing should be adjusted based on weight, with close monitoring for toxicity 1.
  • Elderly: Increased vigilance for complications and supportive care tailored to comorbidities is advised 1.
  • Comorbidities: Management should focus on mitigating the impact of underlying conditions while treating SAHF 1.

    • Key Recommendations

  • Initiate ribavirin therapy intravenously at 5 grams every 6 hours for 4 days in confirmed or highly suspected cases of SAHF (Evidence: Strong 1).
  • Provide comprehensive supportive care including fluid management and blood product transfusions as needed (Evidence: Strong 1).
  • Tailor ribavirin dosing in pediatric patients based on weight and monitor closely for adverse effects (Evidence: Moderate 1).

    • References

    1 Panduro A. The Editorial Challenges Faced by International Medical Journals in Latin America. Annals of hepatology 2018. link

    Original source

    1. [1]
      The Editorial Challenges Faced by International Medical Journals in Latin America. — Panduro A Annals of hepatology (2018)
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