Hemorrhagic fever with renal syndrome: Two case reports

Hantavirus, a member of the family Bunyaviridae, causes two types of infection in humans: hemorrhagic fever with renal syndrome (HFRS) and Hantavirus cardiopulmonary syndrome (HCPS). HFRS, first reported in Turkey in 2009, is related with renal insufficiency, hypotension, bleeding and increase in vascular permeability. Two patients were admitted from Kastamonu with fever, abdominal pain, headache, eye pain, weakness and decrease in appetite. Fever, thrombocytopenia, elevated creatinine and CRP were detected. Crimean-Congo hemorrhagic fever, leptospirosis and HFRS were considered in the differential diagnosis. In the sera of patients, anti-hantavirus IgM (detected with indirect immunofluorescent antibody (IFA) test) and hantavirus immunoblotting assay were positive. In their follow-up, patients recovered from their illness and were discharged. In Turkey, although cases of HFRS were usually reported in the Black Sea region, there was not any case reported from Kastamonu province. HFRS should be considered in the differential diagnosis of cases referred from rural parts of our country with presentation of rapid onset fever, thrombocytopenia and acute renal insufficiency.