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Kidney Week

Abstract: SA-PO101

Hantavirus: A Rare Cause of Rhabdomyolysis

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Singh, Pratiksha, Rutgers Health Community Medical Center, Toms River, New Jersey, United States
  • Toma, Katherine, Jersey Coast Nephrology and Hypertension Associated LLC, Brick, New Jersey, United States
Introduction

Rhabdomyolysis has physical and nonphysical causes including toxins, trauma, and viral infections. Hantavirus presents flu-like symptoms and multisystem involvement including gastrointestinal, renal, and nervous systems.

Case Description

The patient is a 70-year-old male with a history of non-insulin-dependent diabetes, obesity, hyperlipidemia, arthritis, and chronic NSAID use who presented with altered mental status and inability to stand up after a fall eight hours prior. An initial examination found him disoriented, afebrile, and normotensive. Labs revealed a creatinine of 3.37 mg/dl and CK of 59100 U/L. CNS and renal imaging were all unremarkable. The patient became anuric on hospital day three and required continuous renal replacement therapy. On hospital day four he became febrile (101F). He was treated with aztreonam, vancomycin, cefepime, and empiric coverage with doxycycline. All blood cultures were negative. Collateral information was obtained from the family, who found his home in great disarray and infested with rats. This prompted testing for Hantavirus, which returned positive. The patient’s renal function eventually recovered, with a creatinine of 3.26 mg/dl.

Discussion

Hoarders are at increased risk of exposure to Hantavirus due to contact with rodent droppings, saliva, urine in poorly ventilated areas. This is easily missed unless emphasis to social history including hobbies are explored. It is imperative to focus on The Social determinants of health for timely diagnosis and management.

Investigations
Blood cultureNegative
Urine CultureNegative
ANANegative
Anti-Jo1 AbNegative
PM/Scl AbNegative
Antimitochondrial AbNegative

CPK trend