SHM Converge Scientific Abstract ePoster Gallery-Mouse in the Monastery: Vv Ecmo for a Patient With Severe Hantavirus Pulmonary Syndrome

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This document describes a severe case of Hantavirus Pulmonary Syndrome (HPS), a rare but highly fatal zoonotic disease transmitted mainly by deer mice in North America. HPS typically affects adult males and is associated with rodent exposure in homes, workplaces, or recreational settings, with most cases occurring in spring and summer. Early symptoms are nonspecific, including fever, fatigue, and muscle aches, but the illness can rapidly progress to cough, dyspnea, and pulmonary edema. The mortality rate is about 40%.<br /><br />The case involves a patient who presented with acute cough, shortness of breath, and left-sided chest pain, then quickly worsened and required intubation and transfer. Imaging showed bilateral pulmonary opacities and edema. Despite treatment for presumed pneumonia, respiratory viral testing, including COVID-19 and influenza, was negative, and bronchoscopy with cultures showed no growth. As hypoxia worsened, the patient required veno-venous extracorporeal membrane oxygenation (VV ECMO) on hospital day 7. A key exposure history emerged: the patient had been living in a monastery grain silo infested with rodents, and another monk had a similar fatal illness. Hantavirus IgM testing confirmed the diagnosis of HPS.<br /><br />The patient ultimately developed multi-organ failure, severe lactic acidosis, and cardiovascular collapse, and care was withdrawn after discussion with the family. The case highlights how HPS can mimic other causes of respiratory failure, leading to diagnostic delay. It emphasizes the importance of early recognition of rodent exposure, public health awareness in shared living environments, and supportive management, including ECMO in severe cases.

Asset Subtitle

Kyle Weinstein

Meta Tag

Author List Daniel Hulgan, Gary Weinstein, Jordan Wood, Kyle Weinstein, Richard Kim

Category Clinical Vignettes

Concept Hantavirus Pulmonary Syndrome

Concept Rodent Exposure

Concept Clinical Presentation

Concept Exposure History

Concept Supportive Care

Distinguished Non-Finalist

Presenter Organization Texas Health Resources Dallas

Presenting Author Kyle Weinstein

Track Adult

Keywords

Hantavirus Pulmonary Syndrome

HPS

rodent exposure

deer mice

pulmonary edema

acute respiratory failure

VV ECMO

zoonotic disease

monastery grain silo

IgM testing

Hantavirus Pulmonary Syndrome

Rodent Exposure

Clinical Presentation

Exposure History

Supportive Care