Category: Family Health

Necrotizing skin infections, including necrotizing cellulitis and necrotizing fasciitis, are severe forms of cellulitis. These infections cause infected skin and tissues to die (necrosis).

• The infected skin is red, warm to the touch, and swollen, and gas bubbles may form under the skin.

• The person usually has intense pain, feels very ill, and has a high fever.

• The diagnosis is based on a doctor’s evaluation, x-rays, and laboratory tests.

• Treatment involves removing dead skin and tissue, which sometimes requires extensive surgery, and giving intravenous antibiotics.

(See also Overview of Bacterial Skin Infections.)

Most skin infections do not result in the death of skin and nearby tissues. Sometimes, however, a bacterial infection can cause small blood vessels in the infected area to clot. This clotting causes the tissue fed by these vessels to die from lack of blood. Dead tissue is termed necrotic. Because the body’s immune defenses that travel through the bloodstream (such as white blood cells and antibodies) can no longer reach this area, the infection spreads rapidly and may be difficult to control. The infection can be fatal, even with appropriate treatment.

Some necrotizing skin infections spread deep in the skin along the surface of the connective tissue that covers muscle (fascia) and are termed necrotizing fasciitis. Other necrotizing skin infections spread in the outer layers of skin and are termed necrotizing cellulitis. Several different bacteria, such as Streptococcus and Clostridia, may cause necrotizing skin infections, but in many people the infections are caused by a combination of bacteria. The necrotizing skin infection caused by streptococci in particular has been termed “flesh-eating disease” by the lay press, but it differs little from the others. Gas gangrene (also called clostridial myonecrosis) is a type of necrotizing skin infection that affects the muscle and surrounding tissues and is typically caused by Clostridia.

Some necrotizing skin infections begin at puncture wounds or other skin injuries, particularly wounds contaminated with dirt and debris. Other infections begin in surgical incisions or even in healthy skin. Sometimes people with diverticulitis, intestinal perforation, or tumors of the intestine can develop necrotizing infections of the abdominal wall, genital area, or thighs. These infections occur when certain bacteria spread from the intestine and into the skin. The bacteria may initially create an abscess (a pocket of pus) in the abdominal cavity and spread directly outward to the skin, or they may spread through the bloodstream to the skin and other organs. People with diabetes, cancer, an alcohol use disorder, injection drug use, or chronic kidney disease or who have a weakened immune system are at increased risk of necrotizing skin infections.

Symptoms of Necrotizing Skin Infections

Symptoms of necrotizing skin infections often begin as the common skin infection, cellulitis. The skin may look pale at first but may quickly become red or bronze and warm to the touch and swollen. Pain is intense.

Later, the skin turns violet, often with the development of large fluid-filled blisters (bullae). The fluid from these blisters is brown, watery, and sometimes foul smelling. Areas of dead skin turn black (gangrene).

Some types of necrotizing skin infection, including those caused by Clostridia and mixed bacteria, produce gas. The gas creates bubbles under the skin and sometimes in the blisters themselves, causing the skin to feel crackly when pressed. Initially the infected area is extremely painful, but as the skin dies, the nerves stop working and the area loses sensation, so pain goes away of decreases. The muscles may be affected as the infection worsens.

The person usually feels very ill and has a high fever, a rapid heart rate, and mental deterioration ranging from confusion to unconsciousness. Blood pressure may fall because of toxins secreted by the bacteria and the body’s response to the infection (septic shock). People may develop toxic shock syndrome.

Diagnosis of Necrotizing Skin Infections

• A doctor’s evaluation

• Laboratory tests

A doctor makes a diagnosis of necrotizing skin infection based on its appearance, particularly the presence of gas bubbles that can be seen under the skin. X-rays may show gas under the skin as well.

A blood test usually shows that the number of white blood cells has increased (leukocytosis). The specific bacteria causing the infection are identified by laboratory analysis of blood or tissue samples (culture). However, doctors begin treatment before they have the laboratory test results.

Treatment of Necrotizing Skin Infections

The treatment of necrotizing fasciitis and gas gangrene is surgical removal of the dead tissue plus antibiotics given by vein (intravenously). Large amounts of skin, tissue, and muscle often must be removed, and, in some cases, affected body parts may have to be removed (amputated).

People may need large volumes of intravenous fluids before and after surgery.

Prognosis for Necrotizing Skin Infections

Necrotizing skin infections are fatal in about 20 to 30% of people who receive appropriate treatment. Without treatment, these infections are almost always fatal.

Older adults, those who have other chronic medical disorders, and those in whom the infection has reached an advanced stage have a poorer outcome. A delay in diagnosis and treatment and insufficient surgical removal of dead tissue worsen the prognosis.

The skin provides a remarkably good barrier against bacterial infections. Although many bacteria come in contact with or reside on the skin, they normally do not cause an infection. When bacterial skin infections do occur, they can range in size from a tiny spot to spots or sores over the entire body surface. They can range in seriousness as well, from harmless to life threatening.

Bacterial skin infections develop when bacteria enter through hair follicles or through small breaks in the skin that result from scrapes, punctures, surgery, burns, sunburn, animal or insect bites, wounds, and pre-existing skin disorders. People can develop bacterial skin infections after participating in a variety of activities, for example, gardening in contaminated soil or swimming in a contaminated pond, lake, or ocean.

Classification of Bacterial Skin Infections

Some infections involve just the skin, and others also involve the soft tissues under the skin. Relatively minor infections include:

More serious bacterial skin and skin structure infections include:

Staphylococcal scalded skin syndrome, scarlet fever, and toxic shock syndrome are skin-related complications of bacterial infections.

Causes of Bacterial Skin Infections

Many types of bacteria can infect the skin. The most common are Staphylococcus and Streptococcus.

Methicillin-resistant Staphylococcus aureus (also known as MRSA) is a common bacteria that causes skin infections in the United States. MRSA is resistant to many commonly used antibiotics because it has undergone genetic changes that allow it to survive despite exposure to some antibiotics. Because MRSA is resistant to several antibiotics that used to kill it, doctors tailor their treatment based on how often MRSA is found in the local area and whether or not it has been found to be resistant to commonly used antibiotics.

Risk Factors for Bacterial Skin Infections

Some people are at particular risk of developing skin infections:

• People with diabetes, who are likely to have poor blood flow (especially to the hands and feet), have a high level of sugar (glucose) in their blood, which decreases their ability to fight infections

• People who are hospitalized or living in a nursing home

• People who are older

• People who have human immunodeficiency virus (HIV), AIDS or other immune disorders, or hepatitis

• People who are undergoing chemotherapy or treatment with other medications that suppress the immune system

• Children under 5 years of age

• Adults over 85 years of age

Skin that is inflamed or damaged is more likely to become infected. In fact, any break in the skin predisposes a person to infection.

Children under 5 years of age and adults over 85 years of age are at a particularly higher risk of developing a bacterial skin infection.

Treatment of Bacterial Skin Infections

• Antibiotics

• Drainage of abscesses

Doctors prescribe an antibiotic ointment for minor skin infections. They prescribe antibiotics that are taken by mouth (orally) or given by vein (intravenously) if a large area of skin is infected.

Abscesses are often cut open (incised) by doctors and allowed to drain, and they surgically remove any dead tissue.

Prevention of Bacterial Skin Infections

Preventing bacterial skin infections involves keeping the skin undamaged and clean. When the skin is cut or scraped, the injury should be washed with soap and water and covered with a sterile bandage.

Petroleum jelly may be applied to areas where small wounds are open or where the skin has peeled off to keep the tissue moist and to try to keep bacteria out. Doctors recommend that people do not use antibiotic ointments (prescription or nonprescription) on uninfected minor wounds because of the risk of developing an allergy to the antibiotic.

Overview

What Is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is a common intestinal problem that affects the colon (the large intestine). It can cause cramps, gas, bloating, diarrhea, and constipation. It’s sometimes called a “nervous stomach” or “spastic colon.”

IBS can be uncomfortable and embarrassing, but it doesn’t cause serious health problems. Doctors can help kids and teens manage IBS symptoms with changes in diet and lifestyle. Sometimes they prescribe medicines to help relieve symptoms.

Top Things to Know

• Irritable bowel syndrome (IBS) is a common digestive condition that affects how the colon works and can cause ongoing belly discomfort.
• Kids with IBS may have belly pain, bloating, gas, diarrhea, constipation, or changes in bowel habits.
• IBS is managed with changes in diet, lifestyle, stress management, and sometimes medicine.
• IBS can be confused with other digestive problems or dismissed as “just a nervous stomach,” but symptoms are real and often linked to stress, food triggers, or gut sensitivity.

What Happens in IBS?

Normally, the colon absorbs water and nutrients from partially digested food. Waste products aren’t absorbed, and move slowly through the colon toward the rectum. Then, they leave the body as feces (poop).

Muscles in the colon help the body do this. They squeeze and relax as they push undigested food through the large intestine. They work with other muscles in the rectum or pelvis to push feces out of the anus.

But with IBS, the colon’s muscles don’t work at the right speed for good digestion or don’t work well with the other muscles. Undigested food in the colon can’t move along smoothly. This can lead to belly cramps, bloating, constipation, and diarrhea.

Signs & Symptoms

What Are the Signs & Symptoms of IBS?

The main sign of IBS is belly pain or discomfort. Other signs include:

• changes in bowel habits (pooping)
• bloating
• belching (burping)
• flatulence (farting)
• heartburn
• nausea (sick to the stomach)
• feeling full quickly when eating

But having gas or a stomachache once in a while doesn’t mean someone has IBS. Doctors consider it IBS when symptoms last for at least three months and include at least two of these signs:

• pain or discomfort that feels better after a bowel movement (BM)
• pain or discomfort together with changes in how often a person has to go to the bathroom
• pain or discomfort along with changes in their stool (poop). Some people get constipated, and their poop is hard and difficult to pass. Others have diarrhea.

Causes

What Causes IBS?

The specific cause of IBS isn’t known, but it tends to run in families.

Some foods — like milk, chocolate, drinks with caffeine, gassy foods, and fatty foods — can trigger IBS symptoms. So can infections, anxiety, and stress. Some kids with IBS are more sensitive to emotional upsets. Nerves in the colon are linked to the brain, so things like family problems, moving, or taking tests can affect how the colon works.

Kids with IBS may be more sensitive to belly pain, discomfort, and fullness than other kids. Sometimes, people never find out what brings on their IBS symptoms.

Diagnosis

How Is IBS Diagnosed?

There is no specific test for IBS. To diagnose it, doctors ask about symptoms and do an exam. They’ll ask if anyone in the family has IBS or other gastrointestinal problems.

Talking about things like gas and diarrhea can be embarrassing for kids. Reassure your child that the doctor deals with issues like this every day and needs the information to help your child feel better.

The doctor may suggest keeping a food diary to see if any foods trigger your child’s IBS symptoms. The doctor might ask about stress at home and at school.

Most of the time, doctors don’t need medical tests to diagnose IBS. Sometimes they order blood tests, stool tests, X-rays, or other tests to be sure another medical problem isn’t causing the symptoms.

Treatment & Care

How Is IBS Treated?

There’s no cure for IBS. But many things can help reduce IBS symptoms, including:

• Changes in eating. Some kids find that careful eating helps reduce or get rid of IBS symptoms. Your child might have to avoid milk and dairy products, caffeine, greasy foods, spicy foods, gluten, sugary drinks, or other foods that seem to bring on problems. Eating smaller, more frequent meals also might help.
• Changes in lifestyle. If IBS is tied to stress, talk about what your child can do to manage pressures related to school, home, or friends.
• Regular exercise. Exercise can help digestion. It’s also a great stress reliever.
• Medicines. Doctors sometimes prescribe medicines to treat diarrhea, constipation, or cramps. Antidepressants may help some people with pain management and depression. Talk with your doctor before giving your child any over-the-counter medicines for diarrhea, constipation, cramps, or other digestive problems.
• Counseling and coping strategies. If your child seems very anxious or depressed, your doctor might recommend seeing a psychologist or therapist. Therapy, hypnosis, breathing exercises, or other relaxation techniques can help some people manage IBS.

IBS can affect your child’s quality of life. Talk with your doctor about ways to manage it to help your child lead an active and healthy life.

Also called: Fever Blisters

Overview

What Are Cold Sores?

Cold sores are small painful blisters that can form on or near the lips or nose. They’re common and usually go away on their own in 1–2 weeks.

Top Things to Know

• Cold sores are small, painful blisters that usually form on or around the lips and nose. They are common in kids and are caused by a virus.
• Kids with cold sores may feel tingling before blisters appear or have pain when eating, and they may also have a fever, swollen gums, or swollen neck glands.
• Cold sores usually heal on their own, but pain-relief medicines and cold compresses can help them be less painful.
• Cold sores can come back because the virus stays in the body.

Signs & Symptoms

What Are the Signs & Symptoms of Cold Sores?

Kids may have tingling and numbness around their mouth before fluid-filled blisters form. When the blisters break, they become sores, which can make eating painful. The sores crust over and form a scab before they go away.

Cold sores also can cause red and swollen gums, a fever, muscle aches, a generally ill feeling, and swollen neck glands.

When Should I Call the Doctor?

Call the doctor if your child:

• is younger than 6 months old and gets a cold sore
• has a weak immune system, which could let the infection spread and cause problems in other parts of the body
• has sores that don’t start healing in 7–10 days
• has any sores near the eyes or eye pain or redness
• gets cold sores a lot
• has symptoms of a bacterial infection, like fever, pus, or redness that spreads
• has other symptoms, like a headache or confusion

Causes & Prevention

What Causes Cold Sores?

The herpes simplex virus type 1 (HSV-1) causes cold sores. It’s contagious and spreads easily from one person to another. This isn’t the same virus as HSV type 2 (HSV-2), which causes sores in the genital area (genital herpes). But even though HSV-1 typically causes sores around the mouth and HSV-2 causes most genital sores, both viruses can cause sores in either body area.

After a child has had cold sores, the virus can quietly stay in the body for a long time without causing symptoms. Later, symptoms can happen again because of things like:

• other infections
• fever
• sunlight
• cold weather
• periods
• stress, like before a big test at school

How Do Kids Get Cold Sores?

Kids can get HSV-1 by kissing or touching someone with cold sores or by sharing eating utensils (like forks, spoons, and chopsticks), towels, or other items with a person who has the virus. Many people with HSV-1 got it as kids during their preschool years (ages 3–5).

Can Cold Sores Be Prevented?

The HSV-1 virus is very contagious. To help prevent it from spreading, kids with a cold sore should:

• Keep their drinking glasses, eating utensils, washcloths, and towels away from those used by other family members. These items should be washed well after use.
• Not kiss others until the sores heal.
• Avoid touching the cold sore.
• Wash their hands well and often.

To help prevent another cold sore, kids should:

• Try to get enough sleep and eat well.
• Try to manage stress, get lots of physical activity, and take time to relax.
• Always wear sunscreen outdoors, particularly on the face, and use a lip balm with SPF.

Treatment & Care

How Are Cold Sores Treated?

Cold sores usually go away in about 1–2 weeks. No medicines can kill the virus. But some treatments can help make cold sores less painful and not last as long.

To ease pain, your child can hold a cold compress (a clean, cold, wet cloth) to their mouth. To make meals more comfortable, serve cool foods and drinks.

You can also give pain medicine like acetaminophen or ibuprofen. Don’t give aspirin to kids with cold sores or other viral infections because it’s linked to a rare but serious illness called Reye syndrome. Your doctor may recommend other medicine to help cold sores feel better and go away.

When your child has a cold sore, they should avoid touching it and be careful not to touch their eyes. If HSV-1 gets into the eyes, it can be very serious.

Overview

What Is a Knee Injury?

The knee is a joint that joins the thighbone (femur) to the top of the shinbone (tibia). It’s made up of bones; muscles; and tissues called cartilage, ligaments, and tendons. These parts work together to let the legs bend, straighten, and turn.

A knee injury is damage to one or more parts of the knee. 

What Are the Types of Knee Injuries?

Common knee injuries in kids and teens include:

Signs & Symptoms

What Are the Signs & Symptoms of a Knee Injury?

Signs and symptoms of a knee injury depend on the cause. Most kids and teens with knee injuries have pain. The knee may also feel weak or like it’s “giving way” or “locking.” They might not be able to fully bend or straighten the knee, which also might be swollen or bruised.

Causes & Prevention

What Causes Knee Injuries?

Kids and teens may hurt a knee in a fall or accident. Others get overuse knee injuries. These happen when someone trains too much for a sport or makes the same motions over and over with the knee.

Can Knee Injuries Be Prevented?

To help prevent knee injuries, make sure kids wear the right protective equipment for sports (like knee pads and shin guards). They also need supportive athletic shoes that are in good condition.

Explain how to move safely. When jumping, kids should bend their knees while landing. And when changing directions or turning quickly (as in soccer), they can try crouching and bending at the knees and hips. This helps protect against an ACL injury.

Remind them to warm up before a workout and cool down after it. They can also do regular strength training to support muscles, and stretching or yoga to be more flexible.

Finally, encourage kids to stay active year-round, even if they’re not playing an organized sport. This can help keep their knees and the rest of them in shape.

Diagnosis

How Are Knee Injuries Diagnosed?

To diagnose a knee injury, doctors ask how it happened and what symptoms it’s causing. They’ll also do an exam where they press on the knee and legs and move them in certain ways. This can help show what part of the knee is hurt.

They might order imaging tests, like an X-ray to check for injuries to the bones, or a CT scan or an MRI to look inside the knee.

Treatment & Care

How Are Knee Injuries Treated?

Treatment for a knee injury depends on the cause. Follow your doctor’s instructions for what activities are OK. If an activity causes pain, your child should stop, then try it later on or the next day.

If your doctor says it’s OK, you can give your child acetaminophen or ibuprofen for pain. Follow the label directions for how much to give and how often.

To help with swelling in the first day or two after the injury, you can:

• Put ice in a towel on the knee for about 20 minutes every one to two hours.
• Wrap an elastic bandage around the knee or use a compression sleeve.
• Raise the knee above the level of the heart.

Some kids and teens with a knee injury may need physical therapy or surgery.

Overview

What Is Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome (PFP syndrome) is pain in and around the kneecap (patella). PFP syndrome is also called “runner’s knee.”

Rest and exercises that stretch and strengthen the hips and legs can help PFP syndrome get better.

Signs & Symptoms

What Are the Signs & Symptoms of PFP Syndrome?

Patellofemoral (peh-tel-oh-FEM-er-ul) pain syndrome causes pain under and around the knee. The pain often gets worse with walking, kneeling, squatting, going up or down stairs, or running. It may also hurt after sitting with a bent knee for a long time, such as in a long car ride or in a movie theater.

Some people with PFP syndrome feel a “popping” or creaking after getting up from sitting or when going up or down stairs.

When Should I Call the Doctor?

If your child has knee pain that does not go away in a few days, call the doctor for an exam to see what is causing the pain. Delaying could make injuries worse. 

Causes & Prevention

What Causes PFP Syndrome?

Patellofemoral pain syndrome is an overuse disorder. These happen when someone does the same movements that stress the knee over and over again.

In PFP syndrome, repeated bending and straightening the knee stresses the kneecap. It’s most common in athletes.

Some people with PFP syndrome have a kneecap that is out of line with the thighbone (femur). The kneecap can get out of line, or wiggle as it moves along the thighbone, because of muscle weakness, trauma, or other problem. If this happens, the kneecap doesn’t glide smoothly over the thighbone when the knee bends and straightens. The kneecap gets injured and this causes the pain of PFP syndrome.

Who Gets PFP Syndrome?

Patellofemoral pain syndrome usually happens in people who play sports that involve a lot of knee bending and straightening, such as running, biking, and skiing

PFP syndrome is more common in women, and happens most often to teens and young adults.

Tight or weak leg muscles, or flat feet, can make someone more likely to get PFP syndrome.

How Is PFP Syndrome Diagnosed?

Your Doctor Can Make a Diagnosis

To diagnose patellofemoral pain syndrome, healthcare providers:

• ask about physical activities
• do an exam

Usually, no testing is needed. Sometimes the healthcare provider orders an X-ray or other imaging study to check for other knee problems.

Treatment & Care

How Is PFP Syndrome Treated?

A child or teen with patellofemoral pain syndrome needs to limit or completely avoid activities that cause pain. Sometimes a change in training is all that’s needed. For example, someone who usually runs hills to train can try running on a flat, soft surface instead.

Someone who has severe pain or pain that interferes with activity (for example, if it causes a limp) needs to rest the knee until the pain is better. For pain:

• Put ice or a cold pack on the knee every 1–2 hours for 15 minutes at a time. Put a thin towel between the ice and your child’s skin to protect it from the cold.
• If your healthcare provider says it’s OK, you can give ibuprofen (Advil, Motrin, or a store brand) or naproxen (Aleve, Naprosyn, or a store brand). Follow the directions that come with the medicine for how much to give and how often. Do not give this medicine for longer than about 2–3 weeks.

Physical Therapy

An important part of the treatment for PFP syndrome is improving the strength and flexibility of the legs, hips, and core muscles. Healthcare providers usually recommend going to a physical therapist to make an exercise plan that will help. The plan may include stretching, squats, planks, lunges, and other exercises that improve strength and flexibility of the legs and hips.

The healthcare provider might also recommend:

• a knee brace
• taping of the knee
• special shoe inserts

It doesn’t happen very often, but sometimes surgery is needed for PFP syndrome.

When Can My Child Return to Sports?

Most people with PFP syndrome need to cut back or stop sports for some time. Follow the healthcare provider’s instructions on when it is safe for your child to go back to sports. This usually is when:

• Hip, leg, and core strength is near normal.
• Flexibility, especially in the hamstring muscle, has improved.
• There’s no pain with everyday activities, such as walking and going up/down stairs.
• Any pain with activity is very mild and goes away within a few minutes of starting the activity.

What Else Should I Know?

It can take months to years for the symptoms from PFP syndrome to get better. Following an exercise plan given by the healthcare provider or physical therapist can help the knee heal. To lower the stress on their knees after healing, young athletes should:

• Warm up and stretch before running or other sports.
• Keep a healthy weight.
• Wear supportive running shoes and replace them often.
• Run on soft, flat surfaces (such as grass, dirt, or a synthetic track with a softer surface).
• Increase the intensity of workouts slowly.
• Use shoe inserts or a knee brace if the healthcare provider recommended it.

Hantavirus infection is a viral disease that is spread from rodents to people. The virus can cause severe infections of the lungs (with cough and shortness of breath) or kidneys (with abdominal pain, and sometimes kidney failure).

• Hantaviruses are spread through contact with infected rodents or their droppings.

• The infection starts with sudden fever, headache, muscle aches, and sometimes abdominal symptoms, which may be followed by a cough and shortness of breath or by kidney problems.

• Blood tests to identify the virus can confirm the diagnosis.

• Oxygen and medications to stabilize blood pressure are used if the lungs are affected, and dialysis may be needed if the kidneys are affected.

(See also Overview of Arbovirus, Arenavirus, and Filovirus Infections.)

Hantaviruses infect various species of rodents throughout the world. The virus is present in the urine and feces of the rodents. The infection is spread when people have contact with rodents, their droppings or urine, or possibly when they inhale virus particles in places with large amounts of rodent droppings. Most hantaviruses do not spread from person to person; rarely, Andes hantavirus in southern South America spreads directly between people in close physical contact. Hantavirus infections are becoming more common.

There are several species of hantavirus. Depending on the species the virus affects different organs:

• The lungs, causing hantavirus pulmonary syndrome (HPS)

• The kidneys, causing hemorrhagic fever with renal syndrome (HFRS)

However, many symptoms of the 2 infections overlap.

The pulmonary syndrome has been found in the western United States and Canada as well as countries in Central and South America.

The renal syndrome occurs primarily in parts of Europe, Korea, China, and Russia. This virus is spread by brown Norway rats and has been spread throughout the world by rats on ships. A few cases of HFRS hantavirus infection, spread by pet or laboratory rats, have occurred in the United States, Canada, and Europe.

Symptoms of Hantavirus Infection

Symptoms of hantavirus infection begin with sudden fever, headache, and muscle aches, typically about 2 weeks (but possibly as long as 6 weeks) after exposure to the rodent droppings or urine. People may also have abdominal pain, diarrhea, or vomiting.

These symptoms continue for several days.

People with pulmonary syndrome then develop a cough and shortness of breath, which may become severe within hours. Fluid collects around the lung, and blood pressure becomes low.

The pulmonary syndrome causes death in up to about 50% of people. Those who survive the first few days improve rapidly and recover completely in about 2 to 3 weeks.

In some people with hemorrhagic fever with renal syndrome, the infection is mild and does not cause symptoms.

In others, vague symptoms (such as a high fever, muscle aches, headache, and nausea) begin suddenly. People with mild symptoms recover completely.

In others, symptoms become severe. Very low blood pressure (shock) develops in a few people. Kidney failure develops, and urine production may stop (called anuria). People may have blood in their urine and/or stool and bruises on their skin. Death occurs in up to 15%, depending on the strain of the virus and a person’s underlying medical problems. Of those who survive, most recover in 3 to 6 weeks, but recovery may take up to 6 months.

Diagnosis of Hantavirus Infection

Hantavirus infection is suspected when people who may have been exposed to the virus have characteristic symptoms.

Blood tests to identify the virus can confirm the diagnosis.

Doctors do other blood tests to evaluate the function of the kidneys and other organs. If the pulmonary syndrome is suspected, a chest x-ray may be done. Echocardiography (ultrasound of the heart) is usually done to exclude other cardiac causes of fluid around the lungs.

Treatment of Hantavirus Infection

• Supportive care

• For the pulmonary syndrome, oxygen and medications to stabilize blood pressure

• For the hemorrhagic fever renal syndrome, dialysis and the antiviral medication ribavirin