Cases in Simulated Disaster Medicine | Chapter 24

Document Type

Book Chapter

Publication Date

2-6-2026

Editor

Andrew Milsten and John Broach

Abstract

A 45-year-old male presents to the emergency department with severe respiratory distress after developing symptoms of fever, chills, myalgias, and a nonproductive cough five days ago. The patient had recently returned from a hiking trip in Yellowstone National Park, where he cleaned a cabin that had rodent nests and droppings. Upon arrival, he is hypoxic and requires supplemental oxygen and intubation. His condition worsens, developing hypotension requiring vasopressor support. Laboratory findings reveal leukocytosis with immunoblasts, thrombocytopenia, and elevated lactate. The patient is diagnosed with Hantavirus cardiopulmonary syndrome (HCPS), a condition linked to rodent exposure, specifically to the inhalation of viral particles from infected rodent droppings. Treatment focuses on advanced airway management, fluid resuscitation, and close monitoring of hemodynamic status. The patient requires intensive care unit admission, and state and local health departments must be notified due to the public health implications of HCPS.

First Page

166

Last Page

169

Chapter Title

Chapter 24 - From Cabin Cleanup to Critical Care

Publisher

Cambridge University Press

ISBN

[9781009279024, 9781009279017]

Rights

© Cambridge University Press 2026

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