Objective To investigate the clinical features,treatment response and prognosis of patients with severe hemorrhagic fever with renal syndrome and complicated with acute anhemopoisis.Methods The clinical features of 18 patients with hemorrhagic fever with renal syndrome complicated with acute anhemopoisis were retrospectively analyzed.Resalts The clinical manifestations of the 18 adult patients(10 males and 8 females,age ranged from 14 to 55 years)with hemorrhagic fever with renal syndrome showed irregular fever,abrupt anemia and multiple sites hemorrhage at the severe stage(9-25 days after the onset).Peripheral leucocytes counts reduced to(2.3-3.2)×109/L,platelet to(23-31)×109/L,erythrocytes to(2.23-2.79)×1012/L,hemoglobulin to 52-67 g/L and reticulocyte to 0-0.002.Bone marrow test results showed that the hyperplasia of erythrocytes series decreased.The ratio of granulocyte to erythroeyte was significantly elevated,while granuloeyte and megalocaryocyte series decreased.The specific manifestations of acute anhemopoiesis were abrupt anemia,irregular fever and multiple sites hemorrhage.The major combined treatments were cortecosteroids and blood transfusion.These patients recovered at 26-60 days after the onset of the disease.Conclusions Hantaan virus could attack human bone marrow cells and induce cytopathogenic effect.In the course of hemorrhagic fever with renal syndrome,acute anhemopoisis could occur.The prognosis of these complicated cases is usually favorable.

The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.