Volume 5, Number 5—October 1999
Dispatch
Acute Sin Nombre Hantavirus Infection without Pulmonary Syndrome, United States
Paul T. Kitsutani*
, 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*
, 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*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.
