Radiologic manifestations of epidemic haemorrhagic fever with renal syndrome.

Epidemic haemorrhagic fever is a viral disease characterized by acute febrile onset followed by profound renal dysfunction. The endemic areas are widespread throughout the Eurasian continent and the Japanese islands. The patient with EHF usually seeks medical care as an emergency for an "acute abdomen". Consequently the X-ray examination becomes an essential part of the clinical study. We analysed the plain abdomen and chest films of 62 patients with this disease. The radiologic manifestations represented diffuse capillary damage with resultant oedema and haemorrhage, particularly in the retro-peritoneal space. Abnormal findings were seen in 94% of the patients on the plain abdomen, and in 63% on the chest film. The most significant finding was obliteration and blurring of anatomical detail in both intra- and retro-peritoneal cavities and renal enlargement. We believe that simultaneous presence of oedema and effusion in both intra- and retro-peritoneal cavities along with renal enlargement is in practice pathognomic of EHF. Obliteration of the renal outline and cardiomegaly with overt lung oedema was associated with the most severe renal dysfunction.