Síndrome pulmonar e cardiovascular por hantavírus: aspectos clínicos de uma doença emergente no sudeste brasileiro / Pulmonary and cardiovascular syndrome due to hantavirus: clinical aspects of an emerging disease in southeastern Brazil
Rev. Soc. Bras. Med. Trop
;
42(3): 282-289, May-June 2009. ilus, tab
Article
in Portuguese
| LILACS
| ID: lil-522257
RESUMO
A síndrome pulmonar e cardiovascular por hantavírus é doença causada pela aspiração de aerossóis dos dejetos de roedores silvestres contaminados por vírus da família Bunyaviridae. Estudamos manifestações clínicas e laboratoriais de 70 casos ocorridos de 1998 a 2007 na região de Ribeirão Preto, SP. A freqüência de sintomas foi dispnéia (87 por cento), febre (81 por cento), tosse (44 por cento), cefaléia (34 por cento), taquicardia (81 por cento), hipotensão arterial (56 por cento), hipóxia (49 por cento), acidose metabólica (57 por cento), linfocitopenia (51 por cento), hematócrito >45 por cento (70 por cento), leucocitose com desvio à esquerda (67 por cento), creatinina (51 por cento) e uréia (42 por cento) séricas elevadas. A letalidade (54,3 por cento) ocorreu principalmente no 4o dia. Insuficiência respiratória, hipotensão arterial e choque ocorreu 24-48 horas; o hematócrito elevado e a plaquetopenia são sinais fortemente sugestivos da doença. A hipótese diagnóstica de pneumonia atípica associada a bom prognóstico (p0,0136); a infusão hídrica >2.000ml e hipotensão arterial associadas a mau prognóstico (p0,0286 e p0,0453).
ABSTRACT
Pulmonary and cardiovascular syndrome due to hantavirus is a disease caused by inhalation of aerosols from the excreta of wild rodents contaminated by viruses of the Bunyaviridae family. We studied the clinical and laboratory manifestations of 70 cases that occurred in the region of Ribeirão Preto, SP, Brazil, between 1998 and 2007. The frequency of symptoms was as follows dyspnea (87 percent), fever (81 percent), coughing (44 percent), headache (34 percent), tachycardia (81 percent), low arterial blood pressure (56 percent), metabolic acidosis (57 percent), lymphocytopenia (51 percent), hematocrit > 45 percent (70 percent), leukocytosis with left deviation (67 percent), creatinine (51 percent) and urea (42 percent). Mortality (54.3 percent) occurred mainly on the fourth day. Respiratory insufficiency, low arterial blood pressure and shock occurred after 24 to 48 hours. High hematocrit and decreased platelet levels were signs strongly suggestive of the disease. The diagnostic hypothesis of atypical pneumonia was associated with a good prognosis (p = 0.0136). Fluid infusion greater than 2,000 ml and arterial hypotension were associated with a poor prognosis (p = 0.0286 and p = 0.0453).
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Cardiovascular Diseases
/
Hantavirus Pulmonary Syndrome
/
Communicable Diseases, Emerging
Type of study:
Diagnostic study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
Portuguese
Journal:
Rev. Soc. Bras. Med. Trop
Journal subject:
Tropical Medicine
Year:
2009
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade Estadual Santa Cruz/BR
/
Universidade de São Paulo/BR
/
Universidade do Sul de Santa Catarina/BR
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