BMJ Case Reports 2011; doi:10.1136/bcr.06.2011.4326
  • New disease

An emerging infectious cause of renal impairment in the UK

  1. William Tong3
  1. 1Department of Infectious Diseases, Guy’s & St Thomas’s Hospitals, London, UK
  2. 2Department of Acute Medicine and Elderly Care, Guy’s & St Thomas’s Hospitals, London, UK
  3. 3Department of Virology, Guy’s & St Thomas’s Hospitals, London, UK
  1. Correspondence to Dr Caoimhe Nic Fhogartaigh, caoimhe77{at}


Hantaviruses are endemic in many central European countries, particularly the Balkans, infection causing non-specific ‘flu-like symptoms and renal dysfunction which is self-limiting in the majority of cases. In this case, there was a diagnostic delay, resulting in numerous unnecessary investigations, prolonged hospital stay and almost an invasive renal biopsy. A travel history is therefore essential, to establish travel to an endemic region within the previous 2–6 weeks. With increasing travel and immigration, hantavirus is likely to be seen more frequently as an imported infection into the UK. However, further research is required to establish the potential for acquisition of infection here, as the animal host, the bank vole, is part of local wildlife. Therefore, the authors urge physicians to be alert to this possibility when faced with acute renal failure in association with an undiagnosed febrile illness, particularly when there is a history of an appropriate environmental or animal exposure.


  • Competing interests None.

  • Patient consent Obtained.

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