27-Year-Old Male Recovers from Hantavirus Infection with Timely Antiviral Treatment and Supportive Care

In this clinical case study, we explore the recovery journey of a 27-year-old male patient, referred to as Xiao Liu for privacy protection, who contracted Hantavirus Hemorrhagic Fever with Renal Syndrome (HFRS). This rare but serious viral illness, often transmitted through rodent exposure, presented with acute fever, facial flushing, fatigue, and signs of kidney dysfunction. Thanks to early diagnosis and a comprehensive treatment plan including antiviral therapy, immune modulation, and supportive care, the patient made a full recovery within three weeks. This article highlights the importance of prompt medical intervention and offers insight into effective management strategies for HFRS.

Case Overview

Patient: Male, 27 years oldDiagnosis: Hemorrhagic Fever with Renal Syndrome (HFRS)Hospital: Huairou District Traditional Chinese Medicine Hospital, BeijingDate of Admission: May 16, 2022Treatment Approach: Combination antiviral and supportive therapy using recombinant human interferon α2b, thymosin injection, dexamethasone acetate, and Salvia miltiorrhiza (Danshen) injectionDuration of Hospitalization: 3 weeksOutcome: Complete resolution of symptoms, normalized laboratory results, successful discharge

Initial Presentation and Diagnosis

The patient was brought to the emergency department by family members in a wheelchair, presenting with a high fever of 40.5°C (104.9°F), marked facial congestion, lethargy, and generalized weakness. He reported that symptoms began the previous night with chills and fever, initially mistaken for influenza. Despite self-medicating with over-the-counter cold remedies, his condition worsened rapidly by noon, progressing to severe headache, body aches, dizziness, loss of appetite, and profound fatigue.

Emergency lab tests revealed significant renal impairment. Urinalysis showed proteinuria and the presence of membrane-like substances in the urine—key indicators associated with HFRS. Upon further history-taking, it emerged that Xiao Liu had gone hiking on a remote section of the Great Wall approximately 10 days prior—an area known to harbor wild rodents. Given the combination of recent outdoor exposure, characteristic symptoms, and abnormal test results, clinicians quickly suspected hantavirus infection as the cause.

Comprehensive Treatment Strategy

Due to the severity of his symptoms and risk of complications, Xiao Liu was immediately admitted for intensive monitoring and treatment. The medical team implemented a multi-pronged therapeutic approach focused on antiviral action, immune support, organ protection, and symptom management.

Antiviral and Immune-Modulating Therapy

To combat the virus directly, intravenous recombinant human interferon α2b was administered to inhibit viral replication. Thymosin injection was added to enhance T-cell function and strengthen the body's natural defenses during this critical phase.

Supportive Care and Symptom Management

Intravenous fluids containing saline and glucose were infused to maintain hydration, stabilize internal homeostasis, and provide essential calories. Physical cooling methods—including ice packs wrapped in towels placed under the armpits and in the groin area—were used to manage persistent high fever safely.

Given the patient's altered mental state and systemic toxicity, low-dose dexamethasone acetate was introduced to reduce inflammation, mitigate cytokine storm effects, and improve overall clinical status. Additionally, due to the increased risk of disseminated intravascular coagulation (DIC)—a life-threatening complication common in severe HFRS cases—Salvia miltiorrhiza (Danshen) injection was given intravenously to promote healthy blood circulation and prevent microvascular thrombosis.

Progress and Clinical Recovery

Xiao Liu's condition improved steadily over the course of treatment:

• Week 1: Fever subsided, with body temperature stabilizing between 36.2°C and 37.3°C. He regained enough strength to walk short distances independently, such as going to the bathroom or getting meals. Appetite improved to about 50% of normal intake.
• Week 2: Mental clarity returned, energy levels increased significantly, and he could walk unassisted in hospital corridors for more than 10 minutes without distress. No recurrence of fever was observed within a 72-hour window.
• Week 3: Follow-up urinalysis, renal function panels, and specialized urine testing showed no abnormalities. With all vital signs stable and symptoms resolved, Xiao Liu was cleared for discharge.

Post-Discharge Guidance and Long-Term Recovery

While Xiao Liu responded well to treatment, full recovery from HFRS requires careful post-hospitalization care. Patients are advised to prioritize rest and avoid strenuous activity for several months after discharge.

Activity Recommendations

Light daily activities such as dressing, eating, and personal hygiene are permitted, but physical exertion should be limited. Most individuals need at least 8–10 weeks before resuming regular routines and three months or more before returning to structured exercise programs.

Nutrition and Lifestyle Adjustments

Diet plays a crucial role in restoring gastrointestinal and immune health. Easily digestible, nutrient-rich foods are recommended, including:

• Milk and dairy products
• Steamed egg custard
• Lean meat porridge
• Fresh vegetables

Patients should strictly avoid alcohol and tobacco, both of which can impair liver and kidney recovery.

Follow-Up Monitoring

Regular outpatient visits are essential. Patients should monitor their blood pressure, blood glucose, and urine output daily. A follow-up appointment at an infectious disease clinic is strongly advised one week after discharge to assess long-term recovery and rule out residual complications.

Key Takeaways: Understanding Hantavirus HFRS

Hemorrhagic Fever with Renal Syndrome (HFRS) is a zoonotic disease primarily caused by hantaviruses carried by rodents, especially rats. Transmission typically occurs when humans inhale aerosolized particles from infected rodent urine, droppings, or saliva—commonly in rural, forested, or abandoned areas.

How Infection Occurs

In Xiao Liu's case, exposure likely occurred during his hike on the wild Great Wall, where contact with contaminated surfaces followed by touching the eyes, nose, or mouth may have allowed viral entry. Alternatively, bites from ectoparasites living on infected rodents could also transmit the virus.

Clinical Course and Prognosis

HFRS progresses rapidly and can lead to severe complications including acute kidney injury, shock, pulmonary edema, and DIC. Delayed treatment increases mortality risk and prolongs recovery time. However, patients who seek care early—especially within the first few days of fever onset—often experience milder disease and better outcomes.

Xiao Liu's timely presentation on day two of illness was a key factor in his favorable prognosis. His case underscores a fundamental principle in managing HFRS: early detection, accurate diagnosis, and immediate treatment are critical to survival and recovery.

Prevention Tips for Outdoor Enthusiasts

For those who enjoy camping, hiking, or exploring abandoned structures:

• Avoid direct contact with rodent nests, droppings, or urine.
• Wear gloves and masks when cleaning enclosed spaces in rural areas.
• Seal food containers and avoid eating outdoors in high-risk zones.
• Wash hands thoroughly after any outdoor activity.

Vaccination against hantavirus is available in some endemic regions and should be considered for individuals living in or frequently visiting high-risk areas.