CTICasesHantavirus Pulmonary Syndrome
Imaging findings
Initial radiographs show diffuse bilateral perihilar and multilobar opacities, with some rounded opacities (asena rosettes) suggesting consolidation in portions of pulmonary lobules. Consolidation is mostly in the lower lung zones. Septal lines are also present throughout the lungs. The heart size is normal. As the opacities improve, pleural fluid accumulation becomes apparent.
Key takeaways
Hantavirus Pulmonary Syndrome (HPS) can present with severe, diffuse bilateral parenchymal opacities and septal lines, mimicking lung edema. In the context of an acute febrile illness, this appearance, along with positive Hantavirus antibodies, is highly consistent with severe HPS, even if a history of rodent contact is not explicitly obtained. Patients can become critically ill, requiring intubation and veno-venous ECMO.
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