Continuous renal replacement therapy rescues severe haemorrhagic fever with renal syndrome in pregnancy: a case report

BMC Infect Dis. 2020 Dec 3;20(1):920. doi: 10.1186/s12879-020-05638-8.

Abstract

Background: Haemorrhagic fever with renal syndrome (HFRS) is a natural epidemic disease caused by various types of viruses of the genus Hantavirus, which are mainly transmitted by contact with the infected rodents and their droppings. Pregnancy complicated with HFRS is rare; however, adverse maternal and foetal outcomes may be noted. In this report, we describe a case involving a pregnant woman with HFRS who was in a state of multiple organ dysfunction syndrome (MODS) and was successfully treated with continuous renal replacement therapy (CRRT).

Case presentation: A 32-year-old pregnant woman at 29 weeks of gestation was hospitalised for a fever and upper respiratory tract infection due to HFRS in winter. Persistent fever, coagulation disorder, thrombocytopenia, electrolyte imbalance, abnormal liver function, and renal failure were noted during the progression of the disease. The patient was treated with CRRT. She recovered after 21 days, and delivered a live infant by caesarean section at 38 weeks of gestation. Furthermore, obvious abnormalities were not detected during the follow-up of the mother and infant at 42 days, 3 months, 6 months, and 1 year after the delivery.

Conclusions: Early diagnosis, timely application of CRRT, and comprehensive treatment may be essential for the successful treatment of patients with HFRS during pregnancy.

Keywords: Case report; Continuous renal replacement therapy; Haemorrhagic fever with renal syndrome; Pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section
  • China / epidemiology
  • Continuous Renal Replacement Therapy / methods*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Hemorrhagic Fever with Renal Syndrome / complications*
  • Hemorrhagic Fever with Renal Syndrome / epidemiology
  • Hemorrhagic Fever with Renal Syndrome / therapy*
  • Hemorrhagic Fever with Renal Syndrome / virology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Multiple Organ Failure / complications*
  • Multiple Organ Failure / therapy*
  • Multiple Organ Failure / virology
  • Orthohantavirus / immunology*
  • Pregnancy
  • Pregnancy Complications, Infectious / therapy*
  • Pregnancy Complications, Infectious / virology
  • Prenatal Care
  • Treatment Outcome