11/05/2026
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Hantavirus: Rodent-borne viral infection that can cause hantavirus pulmonary syndrome (HPS), a severe illness marked by a febrile prodrome followed by rapidly progressive noncardiogenic pulmonary edema, hypoxemia, and shock. In the Americas, infection is usually linked to inhalation of aerosolized rodent urine, droppings, or saliva, with deer mice being a classic reservoir.
🔹 Exposure Clue
➟ History of exposure to rodents or rodent-contaminated dust
➟ Infection usually occurs by inhaling aerosolized rodent excreta
➟ Important epidemiologic clue in the right clinical setting
➟ In the Americas, deer mice are a classic reservoir.
🔹 Prodromal Symptoms
➟ Fever
➟ Severe myalgia, especially involving large muscle groups such as thighs, hips, back, or shoulders
➟ Headache, malaise, and fatigue
➟ Nausea, vomiting, abdominal pain, or diarrhea may occur
➟ Early illness is often nonspecific and can resemble a viral syndrome.
🔹 Cardiopulmonary Phase
➟ After the febrile prodrome, patients may develop cough
➟ Rapidly progressive dyspnea and tachypnea can occur
➟ Respiratory distress may worsen quickly over hours
➟ This phase reflects capillary leak into the lungs.
🔹 Severe Pulmonary Findings
➟ Noncardiogenic pulmonary edema
➟ Hypoxemia
➟ Bilateral pulmonary infiltrates may be seen on chest imaging
➟ Can progress to acute respiratory failure requiring ventilation.
🔹 Hemodynamic Instability
➟ Tachycardia
➟ Hypotension
➟ Capillary leak can contribute to shock
➟ Severe cases may deteriorate rapidly and become critically ill.
🔹 Laboratory / High-Yield Clues
➟ Thrombocytopenia is a classic clue
➟ Hemoconcentration may occur
➟ Leukocytosis can be present
➟ In the right exposure setting, this lab pattern strongly supports suspicion for HPS.
🔹 Diagnosis
➟ Suspect HPS in a patient with rodent exposure + fever/myalgia + rapidly progressive respiratory symptoms
➟ CDC advises testing when symptoms are compatible and rodent exposure is present
➟ Diagnosis is confirmed with specialized hantavirus testing arranged through appropriate laboratories/public health support.
🔹 Management
➟ Supportive care is the main treatment
➟ Early ICU monitoring is critical
➟ Patients may need oxygen, intubation, and mechanical ventilation
➟ Careful hemodynamic support, meticulous volume management, vasopressors, and in severe cardiopulmonary failure, sometimes ECMO, may be required
➟ There is no proven specific antiviral treatment for HPS.
🔹 High-Yield Points
➟ Hantavirus = rodent exposure + fever + severe myalgia + rapid pulmonary edema/hypoxemia
➟ Think of HPS when a viral-like prodrome is followed by sudden respiratory decompensation
➟ Thrombocytopenia + hemoconcentration are classic lab clues
➟ Early recognition and ICU-level supportive care are crucial.
Medical disclaimer: This note is for education only and is not a substitute for professional medical advice, diagnosis, or treatment.
