Qiu FQ, Li CC, Zhou JY. Hemorrhagic fever with renal syndrome complicated with aortic dissection: A case report. World J Clin Cases 2020; 8(22): 5795-5801 [PMID: 33344576 DOI: 10.12998/wjcc.v8.i22.5795]
Corresponding Author of This Article
Jian-Ya Zhou, PhD, Chief Doctor, Professor, Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Xiacheng District, Hangzhou 310003, Zhejiang Province, China. zhoujy@zju.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 26, 2020; 8(22): 5795-5801 Published online Nov 26, 2020. doi: 10.12998/wjcc.v8.i22.5795
Hemorrhagic fever with renal syndrome complicated with aortic dissection: A case report
Feng-Qi Qiu, Cong-Cong Li, Jian-Ya Zhou
Feng-Qi Qiu, Jian-Ya Zhou, Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
Cong-Cong Li, Department of Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
Author contributions: Qiu FQ reviewed the literature and wrote the first draft of the manuscript; Li CC reviewed the literature and contributed to manuscript drafting; Zhou JY analyzed the imaging findings and contributed to manuscript revision; All authors read and approved the final manuscript version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Ya Zhou, PhD, Chief Doctor, Professor, Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Xiacheng District, Hangzhou 310003, Zhejiang Province, China. zhoujy@zju.edu.cn
Received: August 21, 2020 Peer-review started: August 21, 2020 First decision: September 13, 2020 Revised: September 13, 2020 Accepted: September 23, 2020 Article in press: September 23, 2020 Published online: November 26, 2020
Abstract
BACKGROUND
Hemorrhagic fever with renal syndrome is caused by hantaviruses presenting with high fever, hemorrhage, and acute kidney injury. Microvascular injury and hemorrhage in mucus were often observed in patients with hantavirus infection. Infection with bacterial and virus related aortic aneurysm or dissection occurs sporadically. Here, we report a previously unreported case of hemorrhagic fever with concurrent aortic dissection.
CASE SUMMARY
A 56-year-old man complained of high fever and generalized body ache, with decreased platelet counts of 10 × 109/L and acute kidney injury. The enzyme-linked immunosorbent assays test for immunoglobulin M and immunoglobulin G hantavirus-specific antibodies were both positive. During the convalescent period, he complained sudden onset acute chest pain radiating to the back, and the computed tomography angiography revealed an aortic dissection of the descending aorta extending to iliac artery. He was diagnosed with hemorrhagic fever with renal syndrome and Stanford B aortic dissection. The patient recovered completely after surgery with other support treatments.
CONCLUSION
Hemorrhagic fever with renal syndrome complicated with aortic dissection is rare and a difficult clinical condition. Hantavirus infection not only causes microvascular damage presenting with hemorrhage but may be risk factor for acute macrovascular detriment. A causal relationship has yet to be confirmed.
Core Tip: Microvascular injury presenting with hemorrhage in mucus is a typical symptom in hemorrhagic fever with renal syndrome (HFRS) patients. Infection related aortic dissection occurs sporadically, and there has been no report of concurrent HFRS and aortic dissection. HFRS complicated with aortic dissection is rare and a difficult clinical condition that deserves further study and discussion.
