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Analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review

BACKGROUND: Hemorrhagic fever with renal syndrome (HFRS) is an acute disease caused by hantavirus infection and is clinically characterized by fever, various hemorrhagic manifestations and transient renal and hepatic dysfunctions. Although various cases of HFRS have been reported, cases in children...

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Autores principales: Zhang, Li, Ma, Qing-shan, Zhang, Yan, Sun, Bai-chao, Zhao, Leng-yue
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813044/
https://www.ncbi.nlm.nih.gov/pubmed/31646967
http://dx.doi.org/10.1186/s12882-019-1562-0
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author Zhang, Li
Ma, Qing-shan
Zhang, Yan
Sun, Bai-chao
Zhao, Leng-yue
author_facet Zhang, Li
Ma, Qing-shan
Zhang, Yan
Sun, Bai-chao
Zhao, Leng-yue
author_sort Zhang, Li
collection PubMed
description BACKGROUND: Hemorrhagic fever with renal syndrome (HFRS) is an acute disease caused by hantavirus infection and is clinically characterized by fever, various hemorrhagic manifestations and transient renal and hepatic dysfunctions. Although various cases of HFRS have been reported, cases in children have rarely been described. Herein, we report two atypical cases of HFRS in children without distinctive manifestations and typical disease clinically progresses. CASE PRESENTATION: Patient 1 was a 11-year-old girl who attended our clinic for fever accompanying with acute renal failure, proteinuria and decreased level of complement 3 (C(3)) and thrombocytopenia without any hemorrhagic manifestations, acute glomerulonephritis was suspected first, especially lupus nephritis. Patient 2 was misdiagnosed as encephalitis at local hospital because of fever and headache for 4 days. With elevated liver transaminases, proteinuria and normal cerebrospinal fluid examination, HFRS was taken into consideration. Both of the two cases were supported and confirmed by serological test for Hantavirus. CONCLUSIONS: Clinical manifestations of HFRS in children often presented atypically and were milder than adults. Febrile disease accompanying with thrombocytopenia may lead to the suspected diagnosis of HFRS.
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spelling pubmed-68130442019-10-30 Analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review Zhang, Li Ma, Qing-shan Zhang, Yan Sun, Bai-chao Zhao, Leng-yue BMC Nephrol Case Report BACKGROUND: Hemorrhagic fever with renal syndrome (HFRS) is an acute disease caused by hantavirus infection and is clinically characterized by fever, various hemorrhagic manifestations and transient renal and hepatic dysfunctions. Although various cases of HFRS have been reported, cases in children have rarely been described. Herein, we report two atypical cases of HFRS in children without distinctive manifestations and typical disease clinically progresses. CASE PRESENTATION: Patient 1 was a 11-year-old girl who attended our clinic for fever accompanying with acute renal failure, proteinuria and decreased level of complement 3 (C(3)) and thrombocytopenia without any hemorrhagic manifestations, acute glomerulonephritis was suspected first, especially lupus nephritis. Patient 2 was misdiagnosed as encephalitis at local hospital because of fever and headache for 4 days. With elevated liver transaminases, proteinuria and normal cerebrospinal fluid examination, HFRS was taken into consideration. Both of the two cases were supported and confirmed by serological test for Hantavirus. CONCLUSIONS: Clinical manifestations of HFRS in children often presented atypically and were milder than adults. Febrile disease accompanying with thrombocytopenia may lead to the suspected diagnosis of HFRS. BioMed Central 2019-10-23 /pmc/articles/PMC6813044/ /pubmed/31646967 http://dx.doi.org/10.1186/s12882-019-1562-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Zhang, Li
Ma, Qing-shan
Zhang, Yan
Sun, Bai-chao
Zhao, Leng-yue
Analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review
title Analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review
title_full Analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review
title_fullStr Analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review
title_full_unstemmed Analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review
title_short Analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review
title_sort analysis of misdiagnosed cases of hemorrhagic fever with renal syndrome in children: two cases and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813044/
https://www.ncbi.nlm.nih.gov/pubmed/31646967
http://dx.doi.org/10.1186/s12882-019-1562-0
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