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23 Cards in this Set

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On a hot summer day a 49 yo man presents with a 1 week history of fever, muscle ache and malaise and SOB. He was recently camping in the desert in New Mexico. His blood pressure is low. what might he have?
Sin Nombre virus
What is another name of Sin Nombre virus?
hantavirus pulmonary syndrome (HPS)
What is seen on PE and blood work of someone with Sin Nombre virus?
1) hypotension, crackles, fever, tachycardia, tachypnea
2) leukocytosis, elevated bands and thrombocytopenia, low pO2
What is seen on chest X ray of someone with Sin Nombre virus?
interstitial edema with hilar indistinctness
What family does Sin Nombre virus belong to?
bunyavirus
Where do all but one bunyavirus originate?
arthropod, hantavirus is rodent borne
What are the characteristics of hantavirus?
enveloped spherical virus with triple-segmented circular -ssRNA, helically symmetrically capsid
Where do Sin Nombre viruses replicate?
in host cytoplasm
Hantaan virus from Korea causes what?
hemorrhagic fever with renal syndrome that precedes pulmonary edema and DIC
How is Sin Nombre virus diagnosed in the laboratory?
detection of Hantavirus-specific IgM, rising titers of IgG, detection of specific RNA
What is an example of a pan-American zoonosis?
Sin Nombre virus
Human infection with Sin Nombre virus is strongly associated with what?
rodent urine or droppings
How is Sin Nombre virus transmitted?
inhalation
Can Sin Nombre virus be transmitted by person to person contact?
no
Is Sin Nombre virus a risk for bioterrorism?
yes
What is the incubation period of hantavirus?
1-5 weeks
What do pathogenic hantaviruses have?
b3 integrins
What cytokines are involved in the pathogenesis of HPS? What immune cells do the damage?
1) TNF and IL2
2) C8+ kill infected pneumocytes
What are the nonspecific prodrome symptoms of HPS? What follow prodrome symptoms?
1) fever, chills, myalgia, headache, GI
2) B/L infiltrates and respiratory compromise (like ARDS)
On CBC what is seen with Hantavirus?
thrombocytopenia and left shift with increased bands
What is the early key marker you would look for in someone suspected of having Hantavirus?
thrombocytopenia
What is the treatment for Sin Nombre virus?
supportive, give vasopressors,
Why should someone suspected of having Sin Nombre virus be placed on broad spectrum antibiotics?
placed on antibiotics until hantavirus is confirmed. septic shock from bacteria is far more common