Fatal puumala hantavirus infection in a patient with Common Variable Immunodeficiency (CVID)

Puumala hantavirus (PUUV) infections usually show a mild or moderate clinical course, but may sometimes also lead to life-threatening disease. Here, we report on a 60-year-old female patient with common variable immunodeficiency (CVID) who developed a fatal PUUV infection with persistent renal failu...

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Main Authors: Steininger, Philipp (Author) , Herbst, Larissa (Author) , Bihlmaier, Karl (Author) , Willam, Carsten (Author) , Körper, Sixten (Author) , Schrezenmeier, Hubert (Author) , Klüter, Harald (Author) , Pfister, Frederick (Author) , Amann, Kerstin (Author) , Weiss, Sabrina (Author) , Krüger, Detlev H. (Author) , Zimmermann, Robert (Author) , Korn, Klaus (Author) , Hofmann, Jörg (Author) , Harrer, Thomas (Author)
Format: Article (Journal)
Language:English
Published: 21 January 2023
In: Microorganisms
Year: 2023, Volume: 11, Issue: 2, Pages: 1-7
ISSN:2076-2607
DOI:10.3390/microorganisms11020283
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/microorganisms11020283
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2076-2607/11/2/283
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Author Notes:Philipp Steininger, Larissa Herbst, Karl Bihlmaier, Carsten Willam, Sixten Körper, Hubert Schrezenmeier, Harald Klüter, Frederick Pfister, Kerstin Amann, Sabrina Weiss, Detlev H. Krüger, Robert Zimmermann, Klaus Korn, Jörg Hofmann and Thomas Harrer
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Summary:Puumala hantavirus (PUUV) infections usually show a mild or moderate clinical course, but may sometimes also lead to life-threatening disease. Here, we report on a 60-year-old female patient with common variable immunodeficiency (CVID) who developed a fatal PUUV infection with persistent renal failure, thrombocytopenia, and CNS infection with impaired consciousness and tetraparesis. Hantavirus-specific antibodies could not be detected due to the humoral immunodeficiency. Diagnosis and virological monitoring were based on the quantitative detection of PUUV RNA in blood, cerebrospinal fluid, bronchial lavage, and urine, where viral RNA was found over an unusually extended period of one month. Due to clinical deterioration and virus persistence, treatment with ribavirin was initiated. Additionally, fresh frozen plasma (FFP) from convalescent donors with a history of PUUV infection was administered. Despite viral clearance, the clinical condition of the patient did not improve and the patient died on day 81 of hospitalization. This case underlines the importance of the humoral immune response for the course of PUUV disease and illustrates the need for PCR-based virus diagnostics in those patients. Due to its potential antiviral activity, convalescent plasma should be considered in the therapy of severe hantavirus diseases.
Item Description:Gesehen am 16.07.2024
Physical Description:Online Resource
ISSN:2076-2607
DOI:10.3390/microorganisms11020283