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Marijana Petrović1,7, Stanko Petrović2, Katarina Obrenčević1>, Neven Vavić1, Dragan Jovanović1,7, Đoko Maksić1,7, Nemanja Rančić3, Tamara Dragović4,7, Slobodan Obradović5,7, Dejan Pilčević1,7, Jelena Tadić1, Biserka Vukomanović-Đurđević6,7, Ljiljana Ignjatović1, Mirjana Mijušković1,7, Zoran Čukić1
1 Clinic for Nephrology, Military Medical Academy, Belgrade, Serbia,
2 Clinic for Gastroenterology and hepatology, Military Medical Academy, Belgrade, Serbia
3 Centre for Clinical Pharmacology; Faculty of Medicine of the Military Medical Academy,
  University of Defence, Belgrade,  Serbia,
4 Clinic for endocrinology,  Military Medical Academy, Belgrade, Serbia
5 Clinic for Emergency and Internal Medicine, Military Medical Academy,  Belgrade, Serbia
6 Pathology and Forensic Medicine Institute, Military Medical Academy,  Belgrade, Serbia
7 Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia


• The paper was received on 04.02.2016. Accepted on 18.02.2016.





Introduction. Haemorrhagic fever with renal syndrome is acute infectious disease, zoonosis, comes in endemic and epidemic form. It is caused by RNA virus from genus Hantavirus of Bunyaviridae family. Clinical feature advances through 5 stages: febrile phase, hypotensive phase, oliguric phase, diuretic phase and convalescent phase. Fever, bleeding and acute renal failure develop in all patients. Severity of the disease depends on the virus species that causes it.
Case Report. A 31 year old patient was admitted to the hospital due to fever, vomiting and diarrhea, 20 days after military activity. On physical examination he was found to have conjunctival hyperemia, somnolence, arterial hypotension, oliguria. He was transferred to the intensive care unit.  Due to worsening of acute renal failure and anuria hemodialysis treatment was started. Acute heart failure developed, after several days, together with respiratory failure, necessitating mechanical ventilation. ELISA assay confirmed acute infection with Belgrade virus. Diabetes mellitus developed during treatment, requiring insulin treatment. Percutaneous kidney biopsy was performed twice. Respiratory function recovered after treatment but kidney failure grade III remained.
Conclusion. We presented the case of severe form of haemorrhagic fever with renal syndrome, caused by Belgrade virus. Disease complications were heart and respiratory failure and de novo Diabetes mellitus. Haemorrhagic fever with renal syndrome should be suspected in patients with positive epidemiological data and typical clinical feature, establish diagnosis and start treatment as soon as possible.



Key words

haemorrhagic fever with renal syndrome, diabetes mellitus, Belgrade virus.





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PDF Petrovic M. et al. • MD-Medical Data 2016;8(1)

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