Non-infectious conditions such as Goodpasture's syndrome should also be considered. Lack of coryza aids the clinical distinction between HPS and Influenza A infection. It must be remembered that HPS is relatively uncommon and in the immunocompromised PCP, CMV, cryptococcus, aspergillus and graft vs. host disease are far more likely to be the cause of diffuse pulmonary infiltrates than a hantaviral infection. Asymptomatic illness is rare. Radiologic Findings HPS has a characteristic radiological evolution, beginning with minimal changes of interstitial pulmonary edema, progressing to alveolar edema with severe bilateral involvement.
Pleural effusions are common and are often large enough to be evident radiographically.
Heart size is usually normal. Cardiac silhouette size on chest radiographs is usually normal. To view large versions of these images, click directly on the image buttons. M.D. Approximately one-third of patients show evidence of pulmonary edema in the initial radiograph. At the lung bases are Kerley B lines, short linear opacities which are perpendicular to the pleural surfaces.