Unexpected Challenges: A Case Report of Hantavirus Infection in a Pregnant Patient in a Rural Emergency Department

Hantavirus, transmitted primarily by rodents, can cause hantavirus cardiopulmonary syndrome (HCPS) and hemorrhagic fever with renal syndrome (HFRS).

This case details a 28-year-old female, 6 weeks pregnant, who presented with fever to a rural emergency department (ED) in California. Initially, her symptoms were concerning for a possible urinary tract infection (UTI) or viral syndrome, and she was discharged. She returned to the same ED the next day and rapidly deteriorated to shock and cardiac arrest within hours. Serological testing later confirmed hantavirus infection. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the challenges in identifying and managing hantavirus infections in pregnant patients. An emergency physician should be aware of how to identify and manage HCPS as it has a rapid progression, high mortality rate, and nonspecific early symptoms that can be mistaken for more common illnesses. Emergency physicians should be aware of the management of HCPS in pregnant patients, as the interplay between the physiological adaptations of pregnancy and the pathological effects of the disease can significantly complicate acute resuscitation. These complexities heighten the risk of severe complications for both mother and fetus, underscoring the need for timely diagnosis, meticulous supportive care, and vigilant monitoring to avert potentially life-threatening outcomes.