Introduction:

hantavirus disease is an emerging viral zoonosis transmitted by wild rodents. There are two main presentation forms: hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). All pediatric cases published in Uruguay presented HCPS.

Clinical case:

4 year-old patient, from the interior of Uruguay. No previous pathologies. Immunization current. Cohabiting stepfather died 2 weeks previously with a diagnosis of “respiratory sepsis”, an indeterminate anti-Hantavirus IgM. He consulted for vomiting, liquid stools and a fever of 39ºC. He added rhinorrhea and a slight catarrhal cough, without respiratory distress. Noticeable decay. Normal urinary transit. Physical examination: regular general appearance, cutaneous-mucosal pallor, generalized petechiae. Stable hemodynamics. Chest x-ray: diffuse interstitial infiltrates. Hemoglobin 12.5 g/dL, Hct 38.4% white blood cells 15,000/mm³, platelets 30,000/mm³; aspartate aminotransferase 107 IU/l, alanine aminotransferase 10 IU/l, proteins 5.6 g/dL, lactate dehydrogenase: 1,557 IU/l; azotemia 0.58 g/L, creatinine 0.68 mg/dL.

Evolution:

clinical worsening, acute anemia, severe plateletopenia and acute renal failure that did not require replacement therapy. Supportive treatment was performed with good evolution. IgM and IgG positive for hantavirus. Discussion: hantaviruses are a rare zoonosis with high mortality. High diagnostic suspicion must be maintained in patients with epidemiological contact and the different forms of presentation of this disease should be considered. The treatment is supportive. Early identification of cases improves survival through the timely application of support and environmental control measures.

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