Thrombocytopenia, fever, and acute renal failure are characteristic features of nephropathia
epidemica, the predominant hantavirus infection in Europe. However, clinical presentation
and blood cell counts may point to other disorders, such as a hematologic disease,
particularly when impairment of renal function is not evident. This differential diagnosis
often results in further extensive and unnecessary testing. We describe 3 patients
with hantavirus infection with no renal failure, in whom a hematologic disorder was
initially suspected. Serologic testing of hantavirus finally unraveled the mystery,
and outcome of the patients was excellent. It is conceivable that similar cases often
remain undiagnosed. Thus, testing for hantavirus should always be considered in cases
of thrombocytopenia and fever of unknown origin, especially in areas endemic for the
infection.
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