Parameters for assessing the severity of clinical presentation of hemorrhagic fever with kindey syndrome

Abstract

Hemorrhagic fever with kidney syndrome is an acute infectious disease of the zoonotic character, which is characterized by the sudden beginning, high temperature, distinct hemorrhagic syndrome and symptoms and signs of the acute kidney insufficiency. Hemorrhagic fever with kidney syndrome can have mild, moderate and severe clinical picture and the mortality ranges from 5% -15% in our area. The purpose of this study was to try to present criteria on the basis of which it would be possible to forsee, on time, the severity of the clinical picture and to recognize the patient with the most severe disease form. Within the period often years, 87 patients became ill of hemorrhagic fever with kidney syndrome and were treated at General Hospital in Berane, where they were followed from the aspect of clinical and laboratory analyses while the serologic confirmation of the disease was done at the Institute of Immunology and Virology "Torlak" in Belgrade. The results show that the severity of the clinical picture can be forseen on time on the basis of the dynamics of increase of the values of urea and creatinine, duration of the shock condition, duration of the oliguria less than 300 ml/24 h, number of the collapses, presence of the meningitic syndromes and appearance of the asciteses and pleuritic hemorrhage. When, on the basis of these parameters, we classify the patients into the categories of mild, moderate and severe clinical picture, using the appropriate statistics methods we find out the differences in duration of the disease as well as in the result of treatment and number of the dialysed patients. It is possible to forsee clinical course in a patient on time by making timely diagnosis and careful following the clinical and laboratory parameters, important for the result of treatment.