Acute Pericarditis and Viral Infection

Introduction: Hantaviruses is a disease of fever character caused by the virus, RNA from simple tape, of the Bunyaviridae family. Hantaviruses may occur in two clinical types: 1) hemorrhagic fever with renal syndrome in Europe and Asia; 2) cardiopulmonary syndrome by hantaviruses only in Americas. Acute pericarditis is a clinical syndrome with the following characteristics: chest pain, pericardium friction and evolutive alterations of repolarization in the electrocardiogram. The most common etiology is idiopathic and viral. Case report: A man, 38 years old, living at the rural area, with myalgia, arthralgia, fever, loss of appetite, diarrhea, dry cough, chronic headache and retroorbital pain for 5 days. He was diagnosed with classical dengue, so, he received medical treatment with oral hydratation and symptomatical. He went to the Emergency Unit Care - Ribeirao Preto in the 6th day of symptoms, because of the worsening in his clinical condition, with the diagnosis hypothesis of Syndrome of Dengue Shock. Though, serology for dengue was negative. With this result and for the fact that the patient lived in a rural area a survey about the presence of Hantaviruses was made. As the result for the serology had positive for Hantaviruses. With the diagnosis for Cardiopulmonary Syndrome and Pericarditis for Hantaviruses it was made a clinical support to maintain the vital functions, with emphasis in oxygenation and observing the respiratory functions. The patient had satisfactory evolution in the clinical condition. Discussion: Ribeirao Preto is an endemic area for Dengue. Dengue is a fever disease that in its initial phase, has common symptoms with other diseases, like Hantaviruses. This case refers to a patient with clinic and laboratorial exams compatible with Dengue. Though, with the worsening of his symptoms, and the Hypothesis of Shock Syndrome Dengue, treatment began according to the preconizing protocol and the Electrocardiogram identified alterations of repolarization, and the echocardiography was indicated, where the pericardial effusion was evident. Pericarditis was not mentioned as a complication of cardiopulmonary syndrome by hantaviruses. Conclusion: In this report we introduced the case of a patient initially medicated for Dengue and after had Hantaviruses confirmed. EKG helped in the identification and the severity of the illness and the sorological exams defined the infection. Only the clinical board and the epidemiology can't be used for the diagnosis of Dengue. Serology survey is getting more important for these pathologies not being sub notifcated and not treated correctly and conveniently.