Трудность дифференциальной диагностики тяжелого течения геморрагической лихорадки с почечным синдромом, осложненной острым почечным повреждением

Abstract

Hemorrhagic fever with renal syndrome (HFRS) is a zoonotic viral infectious disease which takes the first place in Russia in people morbidity among natural focal infections. The nature of the disease, the severity of its clinical course and the prognosis of HFRS is associated with life-threatening complications which include the infectious-toxic shock, acute liver failure and liver-renal failure, hemorrhagic syndrome characterized by hemorrhages into vital organs. This determines great social and medical significance of this infection. Complex differential search as diagnostic list has tens of nosological forms shows a wide range of symptoms which can clinician occur in recognition of HFRS. The lack of proper experience and caution among clinicians in relation of before occurring rare disease often leads to late diagnosis. The late hospitalization and inadequate therapy of this disease is as a consequence of it. In addition to the polymorphism of clinical manifestations of any infectious disease HFRS can occur not only classically but also has specific course which complicates the early diagnosis stage. It should be noted that clinical features of HFRS are closely related to premorbid background of a patient, his concomitant diseases that determine the severity of course. These facts make this serious problem interesting not only for infectious disease physicians but for physicians of many specialties such as gastroenterologists, neurologists, ophthalmologists and nephrologists. The article presents peculiarities of severe course of HFRS, the difficulty of making early diagnosis and stages of differential diagnosis.