Erste in der Schweiz erworbene Nephropathia epidemica

Summary First case of nephropathia epidemica contracted in Switzerland The patient, a 43-year-old male living in western Switzerland, presented with unprecedented prostration, fever, vomiting, diarrhoea, gastric pain, dysuria and severe thrombocytopenia. After wide-ranging differential diagnosis com- prising urosepsis among others, the patient was diagnosed as having rapid pro- gressive renal failure due to acute tubulointerstitial nephritis. Extensive labo- ratory investigations finally revealed hantavirus-specific positive IgM and IgG by immunoblot technique. The diagnosis of nephropathia epidemica was con- firmed by a hantavirus serotype-specific focus reduction neutralisation test per- formed on the convalescent serum obtained 4½ months after the onset of symp- toms, revealing serotype Puumala virus as the causative agent. The patient was treated symptomatically and could be discharged in good health 10 days after disease onset. Hantaviruses are rodent-borne. This patient must have been in- fected in Switzerland since his last stay abroad had been prior to the upper lim- it of incubation time. Hantavirus infection should therefore be considered in Swiss patients with acute nephritis of unknown origin.