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Title: Een patiënt met rilkoorts, abdominale pijn en trombocytopenie
Author(s): VANDENBERK B, COLAERT J, BOUDEWIJNS M, MEERSSEMAN W, D’HEYGERE F
Journal: Tijdschrift voor Geneeskunde
Volume: 69    Issue: 19   Date: 2013   
Pages: 937-940
DOI: 10.2143/TVG.69.19.2001469

Abstract :
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A patient with a high fever, abdominal pain and thrombocytopenia
A 40-year-old male patient – an avid hunter – consulted after a recent episode of high fever, headache, abdominal pain and deep thrombocytopenia. The urine sediment revealed haematuria and proteinuria. Free abdominal fluid could be found and highly inflammatory blood results were seen.
An acute infection with the Puumala virus (genus Hanta virus, family Bunyaviridae) was withheld. The bank vole functions as a vector for transmission, andmainly lives in agriculturalandforested areas. The genus Hanta virus is responsible for two major clinical images, i.e. “hemorrhagic fever with renal syndrome” (HFRS) and the “Hantavirus (cardio)pulmonary syndrome” (H(C)PS). An infection with Hanta viruses provokes a characteristically high fever, thrombocytopenia and acute renal insufficiency with acute interstitial nephritis. The treatment exists of antipyretics, renal dialysis and cardiotonica when needed. Rarely, a transfusion of thrombocytes is indicated.


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