Imported haemorrhagic fever with renal syndrome caused by Dobrava-Belgrade hantavirus in France

Abstract

Acute kidney injury (AKI) caused by hantavirus infections is rare but should be suspected in any patient presenting with flu-like symptoms, signs of haemolytic-uraemic syndrome or presence of anti-glomerular basement membrane (anti-GBM) antibodies. We report the first case of Dobrava-Belgrade virus in France imported from southeastern Europe. The characteristic macroscopic appearance of the fresh renal biopsy specimen, displaying a haemorrhagic appearance of the medulla, suggested hantavirus infection. AKI caused by hantavirus infections remains a diagnostic challenge, especially outside endemic areas.

Keywords: Dobrava–Belgrade Orthohantavirus; France; acute kidney injury; haemorrhagic interstitial nephritis; hantavirus infection; renal biopsy.