A Case of Hantavirus Pulmonary Syndrome Mimicking Apalastic Anemia with Invasive Aspergillosis

Kyung Don Yoo; Sang Hoon Park; Dae Myung Kim; Ji Young Seo; Hyo Rak Lee; Young Jin Yuh; Sung Rok Kim; Eunah Shin; Soo Jin Yoo

doi:10.5045/kjh.2009.44.3.168

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Yoo, Park, Kim, Seo, Lee, Yuh, Kim, Shin, and Yoo: A Case of Hantavirus Pulmonary Syndrome Mimicking Apalastic Anemia with Invasive Aspergillosis

Case Report

Korean J Hematol 2009;44(3):168-171.

Published online: 20 September 2009

DOI: https://doi.org/10.5045/kjh.2009.44.3.168

A Case of Hantavirus Pulmonary Syndrome Mimicking Apalastic Anemia with Invasive Aspergillosis

Kyung Don Yoo, M.D.¹, Sang Hoon Park, M.D.¹, Dae Myung Kim, M.D.¹, Ji Young Seo, M.D.¹, Hyo Rak Lee, M.D.¹, Young Jin Yuh, M.D.^1,, Sung Rok Kim, M.D.¹, Eunah Shin, M.D.², Soo Jin Yoo, M.D.³

¹Department of Internal Medicine, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea

²Department of Pathology, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea

³Department of Laboratory Medicine, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea

Correspondence to：Young Jin Yuh. M.D. Department of Internal Medicine, Inje University Sanggyepaik Hospital 761-1, Sanggye-7-dong, Nowon-gu, Seoul 139-707, Korea Tel: ＋82-2-950-1460, Fax: ＋82-2-950-1955 E-mail: yj-yuh@paik.ac.kr

Received 14 May 2009 Revised 12 August 2009 Accepted 12 August 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hantavirus is known to a causative agent of hemorrhagic fever with renal syndrome and it can cause hantavirus pulmonary syndrome, a rare disease in Korea. Hantavirus pulmonary syndrome is usually associated with pulmonary hemorrhage and fever. The common hematologic features of this syndrome are elevated hematocrit level, leukocytosis and thrombocytopenia. We report a case of hantavirus pulmonary syndrome with pancytopenia. This patient with severe neutropenia with pulmonary infiltration mimicked aplastic anemia with invasive aspergillosis.

Keywords: Hantavirus pulmonary syndrome, Pancytopenia, Hantavirus

References

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Fig. 1.

A newly developed pulmonary right upper lobe infiltration was observed in chest X-ray taken at admission 6^th day. (A: chest X-ray taken at admission 2^nd day, B: chest X-ray taken at admission 6^th day).

Fig. 2.

The feature of bone marrow biopsy was compatible with aplastic anemia with cellularity less than 5%.

Fig. 3.

Pulmonary right upper lobe infiltration was observed in chest CT.

Fig. 4.

Core needle biopsy of involved lung field showed alveolar hemorrhage without evidence of hyphae (A: ×40, B: ×100).

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