History and admission findings: A 20-year-old woman was admitted to our hospital because of acute renal failure. She was pregnant in the third trimester. She reported on nausea, feeling of sickness, vomiting, abdominal pain and consecutively gross hematuria and sinustachycardia. Under suspicion of premature labour the patient was admitted to an external hospital. An antibiotic therapy with intravenous ampicillin/sulbactam was initiated. Because of acute kidney injury the patient was transferred firstly to the university women's hospital and finally to the department of nephrology. Obesity, the clinical signs of pregnancy, dehydration and small edema of the lower legs were the main medical findings on examination.
Investigations: Laboratory tests revealed hyperuricemia, virological tests detected an acute infection with Dobrava-Belgrade virus. The ultrasonography demonstrated a pregnancy in good condition and a dilated (physiological) renal pelvis but otherwise normal renal morphology.
Diagnosis, treatment and course: A Hantavirus associated acute kidney failure due to infection with the Dobrava-Belgrade virus was diagnosed. The course of the acute renal failure was characterised by remission of all symptoms. Intermittent evaluation by an obstetrician and a nephrologist were done to diagnose maternal and/or fetal complications. A renal replacement therapy was not necessary. At the 41st week of gestation a healthy male infant was born. The development of the newborn was age-appropriate.
Conclusion: Hantavirus infections should be considered in cases of pregnancy-associated acute kidney injury.
© Georg Thieme Verlag KG Stuttgart · New York.