1887

Abstract

Crimean–Congo haemorrhagic fever (CCHF) is a severe disease with a case fatality of 2.8 to 80 %. A patient dwelling in an endemic region for CCHF was admitted with fever preceding bleeding diathesis and pancytopenia. Despite no history of tick exposure, CCHF was highly suspected. With an oral ribavirin therapy, clinical and laboratory improvements were obtained. The diagnosis was confirmed by detection of IgM antibody to CCHF virus and positive RT-PCR. Although the main pathogenesis of CCHF infection is not elucidated yet, haemophagocytosis, a symptom rarely reported in viral haemorrhagic fevers, was observed in this case. Haemophagocytosis is suggested to have a role in the development of pancytopenia in CCHF, the mechanism of which still needs to be investigated, probably with cytokine studies. Together with clinical symptoms and patient history, haemophagocytosis may be an indicator for CCHF.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.46910-0
2007-08-01
2024-05-08
Loading full text...

Full text loading...

/deliver/fulltext/jmm/56/8/1126.html?itemId=/content/journal/jmm/10.1099/jmm.0.46910-0&mimeType=html&fmt=ahah

References

  1. Bakir MUgurlu., MDokuzoguz BBodur., HTasyaran M. A., Vahaboglu H. theTurkish CCHF Study Group 2005; Crimean-Congo haemorrhagic fever outbreak in Middle Anatolia: a multicentre study of clinical features and outcome measures. J Med Microbiol 54:385–389 [CrossRef]
    [Google Scholar]
  2. Baty V., Schuhmacher H., Bourgoin C., Latger V., Buisine J., May T., Canton P. 1998; Hemophagocytic syndrome and hemorrhagic fever with renal syndrome. Presse Med 27:1577
    [Google Scholar]
  3. Centers for Disease Control; 1983; Viral hemorrhagic fever: initial management of suspected and confirmed cases. MMWR Morb Mortal Wkly Rep 32 (Suppl. 2):27S–38S
    [Google Scholar]
  4. Ergonul O., Celikbas A., Dokuzoguz B., Eren S., Baykam N., Esener H. 2004; Characteristics of patients with Crimean-Congo hemorrhagic fever in a recent outbreak in Turkey and impact of oral ribavirin therapy. Clin Infect Dis 39:284–287 [CrossRef]
    [Google Scholar]
  5. Favara B. E. 1992; Hemophagocytic lymphohistiocytosis: a hemophagocytic syndrome. Semin Diagn Pathol 9:63–74
    [Google Scholar]
  6. Fisher-Hoch S. P., Khan J. A., Rehman S., Mirza S., Khurshid M., McCormick J. B. 1995; Crimean-Congo hemorrhagic fever treated with oral ribavirin. Lancet 346:472–475 [CrossRef]
    [Google Scholar]
  7. Fisman D. N. 2000; Hemophagocytic syndromes and infection. Emerg Infect Dis 6:601–608 [CrossRef]
    [Google Scholar]
  8. Hoogstraal H. 1979; The epidemiology of tick-borne Crimean-Congo hemorrhagic fever in Asia, Europe, and Africa. J Med Entomol 15:307–417 [CrossRef]
    [Google Scholar]
  9. Karti S. S., Odabasi Z., Korten V., Yilmaz M., Sonmez M., Caylan R., Akdogan E., Eren N., Koksal I. other authors 2004; Crimean-Congo hemorrhagic fever in Turkey. Emerg Infect Dis 10:1379–1384 [CrossRef]
    [Google Scholar]
  10. Lee J. J., Chung I. J., Shin D. H., Cho S. H., Cho D., Ryang D. W., Khan A. S., Kim H. J. 2002; Hemorrhagic fever with renal syndrome presenting with hemophagocytic lymphohistiocytosis. Emerg Infect Dis 8:209–210 [CrossRef]
    [Google Scholar]
  11. Lu P. L., Hsiao H. H., Tsai J. J., Chen T. C., Feng M. C., Chen T. P., Lin S. F. 2005; Dengue-virus associated hemophagocytic syndrome and dyserythropoiesis: a case report. Kaohsiung J Med Sci 21:34–39 [CrossRef]
    [Google Scholar]
  12. Nabeth P., Ceikh D., Lo B., Faye O., Vall I., Niang M. 2004; Crimean-Congo hemorrhagic fever, Mauritania. Emerg Infect Dis 10:2143–2149 [CrossRef]
    [Google Scholar]
  13. Serter D. 1980; Present status of arbovirus sero-epidemiology in the Aegean region of Turkey. In Arboviruses in the Mediterranean Countries pp 155–161 Edited by Vesenjak-Hirjan J., Caliserh C. Stuttgart: Gustav Fischer Verlag;
    [Google Scholar]
  14. Swanepoel R., Gill D. E., Shepherd A. J., Leman P. A., Mynhardt J. H., Harvey S. 1989; The clinical pathology of Crimean-Congo hemorrhagic fever. Rev Infect Dis 11 (Suppl. 4):S794–S800 [CrossRef]
    [Google Scholar]
  15. Whitehouse C. A. 2004; Crimean-Congo hemorrhagic fever. Antivir Res 64:145–160 [CrossRef]
    [Google Scholar]
  16. Williams R. J., Al-Busaidy S., Mehta F. R., Maupin G. O., Wagoner K. D., Al-Awaidy S., Suleiman A. J., Khan A. S., Peters C. J., Ksiazek T. G. 2000; Crimean-Congo haemorrhagic fever: a seroepidemiological and tick survey in the Sultanate of Oman. Trop Med Int Health 5:99–106 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.46910-0
Loading
/content/journal/jmm/10.1099/jmm.0.46910-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error