Overview
Puumala orthohantavirus (PUUV) infection causes nephropathia epidemica, characterized by acute kidney injury with elevated serum creatinine, proteinuria, and hematuria, often preceded by flu-like symptoms and visual disturbances 1.Diagnosis
Clinical Presentation: Flu-like symptoms, visual disturbances, elevated serum creatinine, proteinuria, hematuria, thrombocytopenia 1.
Laboratory Tests: Elevated serum creatinine, proteinuria, hematuria, thrombocytopenia 1.
Electrocardiogram (ECG): May show transient T-wave inversions, particularly in lateral or inferior leads; exceptionally, marked bradycardia can occur 1.Management
Supportive Care: Fluid management, monitoring renal function, symptomatic treatment 1.
No Specific Antiviral Therapy: No specific antiviral treatment for PUUV infection is mentioned 1.Special Populations
Cardiac Involvement: Transient bradycardia observed; generally benign and resolves spontaneously 1. No specific management noted for special populations 1.Key Recommendations
Monitor renal function and manage fluid balance in patients with PUUV infection (Evidence: Moderate 1).
Consider PUUV infection in the differential diagnosis of unexplained bradycardia in endemic areas (Evidence: Weak 1).
Supportive care remains the cornerstone of management; no specific antiviral therapy is recommended (Evidence: Expert opinion 1).References
1 Pastissier A, Humbert S, Naudion P, Meaux-Ruault N, Badoz M, Magy-Bertrand N. Severe Sinus Bradycardia in Puumala virus infection. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 2019. link