Fatal Puumala Hantavirus infection in a patient with common variable immunodeficiency (CVID)
peer-reviewed
Erstveröffentlichung
2023-01-21Authors
Steininger, Philipp
Herbst, Larissa
Bihlmaier, Karl
Willam, Carsten
Körper, Sixten
Editor
Allen, David J
Wissenschaftlicher Artikel
Published in
Microorganisms ; 11 (2023), 2. - Art.-Nr. 283. - eISSN 2076-2607
Link to original publication
https://dx.doi.org/10.3390/microorganisms11020283Faculties
Medizinische FakultätInstitutions
Institut für Klinische Transfusionsmedizin und Immungenetik Ulm gGmbH (IKT)UKU. Institut für Transfusionsmedizin
Document version
published version (publisher's PDF)Abstract
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.
Subject headings
[GND]: Hanta-Virus | Immunität <Medizin> | Ribavirin | Antikörper | Blutplasma[MeSH]: Hantavirus infections | Encephalitis | Immunity | Ribavirin | Antibodies, Viral | Plasma
[Free subject headings]: Puumala hantavirus | common variable immunodeficiency | convalescent plasma
[DDC subject group]: DDC 610 / Medicine & health
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Please use this identifier to cite or link to this item: http://dx.doi.org/10.18725/OPARU-50447
Steininger, Philipp et al. (2023): Fatal Puumala Hantavirus infection in a patient with common variable immunodeficiency (CVID). Open Access Repositorium der Universität Ulm und Technischen Hochschule Ulm. http://dx.doi.org/10.18725/OPARU-50447
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