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Volume 5, Number 5—October 1999

Dispatch

Acute Sin Nombre Hantavirus Infection without Pulmonary Syndrome, United States

Paul T. Kitsutani*Comments to Author , Robert W. Denton†, Curtis L. Fritz‡, Robert A. Murray§, Randall L. Todd¶#, W. John Pape**, J. Wyatt Frampton††, Joni C. Young*, Ali S. Khan*, Clarence J. Peters*, and Thomas G. Ksiazek*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Bishop, California, USA; ‡California Department of Health Services, Sacramento, California, USA; §California Department of Health Services, Berkeley, California, USA; ¶Bureau of Disease Control and Intervention Services, Carson City, Nevada, USA; #Nevada State Health Division, Carson City, Nevada, USA; **Colorado Department of Public Health & Environment, Denver, Colorado, USA; and ††Utah Department of Health, Salt Lake City, Utah, USA

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Table

Characteristics of five acute cases of Sin Nombre Virus infection without pulmonary syndrome, 1993–1999

Case 1 1993 Case 2 1998 Case 3 1999 Case 4 1998a Case 5 1993b
Age (yr) 38 36 19 32 4
Sex M F M M M
Race White White White White American Indian
State Nevada California Colorado Utah New Mexico
Hospitalized No No Yes Yes No
Symptoms
Fever +c + + + +
Headache + + +
Malaise + +
Myalgia + + + +
Cough + + + +
Shortness of breath +
Chest/substernal pain +
Sore throat + NRd
Nausea/vomiting + + + NR
Dizziness + + NR
Photophobia +
Abdominal pain NR
Diarrhea NR
Arthralgia + NR
Vital signs
Max temp (ºF) 102.5 104.0 103.1 102.8 100.6
Blood pressure normal normal normal normal NR
Lowest O2 sat. (RAe) 85% 94% 89.9% 94% NR
Laboratory results
Highest Hct (%) 47.0 44.7 50.2 44.4 40.2
Highest WBC 9,100 8,000 10,200 7,300 NRf
% seg. neutrophils 68 40 39 88
% bands 9 30 24
% lymphocytes 19 14 20 7
% atypical lymphocytes NR 4 NR NR
Lowest platelet (/mm3) 127,000 115,000 28,000 163,000 NRg
Highest SGOTh (U/L) NR 81 NR 26 NR
Highest LDHi (U/L) NR 337 488 240 NR
Lowest albumin (g/dL) NR 3.1 NR 4.3 NR
Chest X-ray 2-cm granuloma normal Mild left lower lobe infiltrate normal NR
Anti-SNVj antibody
IgM positive positive positive positive positive
IgG positive positive positive positive positive

aObtained from Zavasky D-M, Hjelle B, Peterson M, et al. Acute infection with Sin Nombre hantavirus without pulmonary edema. Clin Infect Dis, in press.
bObtained from Armstrong et al., 1995 (12).
c+, present; -, absent.
dNR = not recorded or obtained.
eRA = room air.
fPatient did not have leukocytosis.
gPatient did not have thrombocytopenia.
hSGOT = serum glutamic oxalacetic acid.
iLDH = lactic dehydrogenase.
jSNV = Sin Nombre virus.

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