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

BMC Infect Dis 2011 Aug 14;11:217. Epub 2011 Aug 14.

Department of Internal Medicine, Oulu University Hospital, Oulu, Finland.

Background: Our 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.

Methods: A 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.

Results: Patients 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.

Conclusions: CNS 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.

Download full-text PDF

Source
http://dx.doi.org/10.1186/1471-2334-11-217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166934PMC
August 2011
13 Reads
5 Citations
2.613 Impact Factor

Publication Analysis

Top Keywords

cns complications
20
major cns
16
puuv igm
12
csf puuv
12
cns
9
patients
9
complications acute
8
nervous system
8
puumala hantavirus
8
patients major
8
csf findings
8
central nervous
8
igm finding
8
laboratory parameters
8
negative csf
8
young male
8
male patients
8
complications
6
csf
6
resonance imaging
4

Similar Publications