Predominant kidney involvement in a fatal case of hantavirus pulmonary syndrome caused by Sin Nombre virus

Abstract

A 27-year-old woman presented to a hospital with symptoms resembling pyelonephritis; respiratory distress did not develop until nearly a day after admission and she subsequently died. The Unexplained Deaths and Criticai Illnesses Project of the Centers for Disease Control and Prevention confirmed Sin Nombre virus infection by the results of serological testing and sequencing of the virai genome; staining of Sin Nombre virus antigen in the pulmonary capillaries was relatively weak.