{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:34:59Z","timestamp":1781879699610,"version":"3.54.5"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Hemorrhagic fever with renal syndrome (HFRS), a natural epidemic disease caused by hantavirus (HV), is one of the viral diseases that pose a major threat to our health. Considering the increasing number of atypical-onset cases reported in some countries, it is important to be familiar with the symptoms of HFRS and the signs of HV infection. This report describes the case of a 55-year-old man with complaints of fever, vomiting, and diarrhea. His symptoms showed no significant improvement after routine anti-infective, antipyretic, and other symptomatic supportive treatments administered at a local clinic. During these treatments, the patient had progressive oliguria; after 3\u2009days, he also developed multiple organ failures, such as the liver and kidney, and was examined for positive serum IgM antibodies to hemorrhagic fever during treatment at our hospital. The patient was finally diagnosed with HFRS followed by multiple organ failure. After antiviral therapy, including ribavirin, piperacillin, and tazobactam, continuous renal replacement therapy, fluid metabolism adjustment, and related supportive therapy were administered, which improved his liver and kidney function. He was discharged on the 25th day after hospitalization. It is difficult to manage patients who develop multiple organ failure after HFRS. Moreover, this condition is rare in clinical settings, with fever being the initial indication. For diseases with unknown origin such as refractory fever and diarrhea, it is crucial to differentiate them from common pathogenic infection and HV infections to provide timely treatment that improves the prognosis of patients.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0078","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T13:55:25Z","timestamp":1684158925000},"page":"101-104","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: Multiple Organ Failure Caused by Hemorrhagic Fever with Renal Syndrome"],"prefix":"10.4269","volume":"109","author":[{"given":"Rui","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-yang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nosocomial Infection Management, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-ting","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Nosocomial Infection Management, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan-yuan","family":"Bu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Chin J Publ Health","first-page":"766","article-title":"Epidemiological study and prevention of hemorrhagic fever with renal syndrome","volume":"20","author":"Song","year":"2004"},{"key":"b2","series-title":"Clin Microbiol Infect","first-page":"e6","article-title":"Hantavirus infections","volume":"21S","author":"Av\u0161i\u010d-\u017dupanc","year":"2019"},{"key":"b3","series-title":"Chin J Infect Dis","first-page":"257","article-title":"Expert consensus on prevention and treatment of hemorrhagic fever with renal syndrome","volume":"39","author":"Zhiliang","year":"2021"},{"key":"b4","series-title":"BMC Infect Dis","first-page":"103","article-title":"A case-control study on the risk factors for hemorrhagic fever with renal syndrome","volume":"20","author":"Wang","year":"2020"},{"key":"b5","series-title":"Immunol Rev","first-page":"163","article-title":"Hantavirus-induced immunity in rodent reservoirs and humans","volume":"225","author":"Schonrich","year":"2008"},{"key":"b6","series-title":"Virol Sin","first-page":"32","article-title":"Hantavirus infection: a global zoonotic challenge","volume":"32","author":"Jiang","year":"2017"},{"key":"b7","series-title":"Emerg Infect Dis","first-page":"1195","article-title":"Hantavirus infections in humans and animals, China","volume":"16","author":"Zhang","year":"2010"},{"key":"b8","series-title":"Euro Surveill","first-page":"19961","article-title":"A five-year perspective on the situation of haemorrhagic fever with renal syndrome and status of the hantavirus reservoirs in Europe, 2005\u20132010","volume":"16","author":"Heyman","year":"2011"},{"key":"b9","series-title":"Lancet","first-page":"1036","article-title":"Serological evidence for Hantaan-related virus in Africa","volume":"2","author":"Gonzalez","year":"1984"},{"key":"b10","series-title":"Viruses","first-page":"610","article-title":"Progress on the prevention and treatment of hantavirus disease","volume":"11","author":"Brocato","year":"2019"},{"key":"b11","series-title":"J Clin Virol","first-page":"25","article-title":"Hemorrhagic fever with renal syndrome in Albania. 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