Young male patients are at elevated risk of developing serious central nervous system complications during acute Puumala hantavirus infection

BMC Infectious Diseases

Research Article

Seppo Rytky¹  Eija Pääkkö²  Ari Karttunen²  Heikki Kauma³  Pasi I Salmela³  Timo Hautala³  Nina Hautala⁴  Olli Vapalahti⁵  Antti Vaheri⁵  Tarja Sironen⁵  Alexander Plyusnin⁵  Saara-Mari Mähönen⁶  Olli Vainio⁷ 

[1] Department of Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland;Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland;Department of Internal Medicine, Oulu University Hospital, Oulu, Finland;Department of Ophthalmology, Oulu University Hospital, Oulu, Finland;Department of Virology, Infection Biology Research Program, Haartman Institute, University of Helsinki, Helsinki, Finland;Institute of Diagnostics, Department of Medical Microbiology and Immunology, University of Oulu, Oulu, Finland;Institute of Diagnostics, Department of Medical Microbiology and Immunology, University of Oulu, Oulu, Finland;Clinical Microbiology Laboratory, Oulu University Hospital, Oulu, Finland;

关键词: hantavirus;    encephalitis;    hypopituitarism;   

DOI  :  10.1186/1471-2334-11-217

 received in 2011-02-08, accepted in 2011-08-14,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundOur aim was to characterize clinical properties and laboratory parameters in patients with or without cerebrospinal fluid (CSF) findings suggestive of central nervous system (CNS) involvement, and especially those who developed serious CNS complications during acute nephropathia epidemica (NE) caused by Puumala hantavirus (PUUV) infection.MethodsA prospective cohort of 40 patients with acute NE and no signs of major CNS complications was analyzed. In addition, 8 patients with major CNS complications associated with NE were characterized. We collected data of CNS symptoms, CSF analysis, brain magnetic resonance imaging (MRI) results, electroencephalography (EEG) recordings, kidney function, and a number of laboratory parameters. Selected patients were evaluated by an ophthalmologist.ResultsPatients with a positive CSF PUUV IgM finding or major CNS complications were more often males (p < 0.05) and they had higher plasma creatinine values (p < 0.001) compared to those with negative CSF PUUV IgM. The degree of tissue edema did not explain the CSF findings. Patients with major CNS complications were younger than those with negative CSF PUUV IgM finding (52.9 vs. 38.5 years, p < 0.05). Some patients developed permanent neurological and ophthalmological impairments.ConclusionsCNS and ocular involvement during and after acute NE can cause permanent damage and these symptoms seem to be attributable to true infection of the CNS rather than increased tissue permeability. The possibility of this condition should be borne in mind especially in young male patients.

【 授权许可】

CC BY   
© Hautala et al; licensee BioMed Central Ltd. 2011