Early Chest Imaging in Patients with Puumala Hantavirus Infection

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• Puumala virus infection, a common cause of hemorrhagic fever with renal syndrome, can present with pulmonary complications.
• Early identification of chest imaging findings is crucial for managing Puumala virus infection.

Observation:

• A retrospective study analyzed chest X-rays (CRX) and high-resolution computed tomography (HRCT) in 64 patients with confirmed acute Puumala virus infection.
• CRX were evaluated for early abnormalities, with HRCT performed in a subset of patients.

Findings:

• Abnormalities were detected in 51.5% of CRX, most commonly linear atelectasis (29.7%) and small pleural effusion (20.3%).
• HRCT revealed interlobular septal thickening in four patients and a crazy-paving pattern with consolidations in one patient with adult respiratory distress syndrome.
• These findings highlight that while uncommon, severe pulmonary involvement can occur in Puumala virus infection.

Implications:

• Chest imaging, particularly CRX, can detect early pulmonary abnormalities in Puumala virus infection.
• Findings like atelectasis and pleural effusion are common, while more severe patterns like crazy-paving are rare but indicate significant lung involvement.
• Radiologists should consider Puumala virus infection in the differential diagnosis of patients presenting with these specific chest imaging findings, especially in endemic areas.