Fatal Crimean-Congo Hemorrhagic Fever with an Atypical Clinical Course during the COVID-19 Pandemic

Background: Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonotic disease characterized by high fever, bleeding manifestations, and a high mortality rate. Most patients begin to experience bleeding 5 to 7 days after the onset of the illness, usually while hospitalized. This report highlights t...

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Main Author: Mustafa Arslan
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2025-03-01
Series:Journal of Arthropod-Borne Diseases
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Online Access:https://jad.tums.ac.ir/index.php/jad/article/view/1641
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author Mustafa Arslan
author_facet Mustafa Arslan
author_sort Mustafa Arslan
collection DOAJ
description Background: Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonotic disease characterized by high fever, bleeding manifestations, and a high mortality rate. Most patients begin to experience bleeding 5 to 7 days after the onset of the illness, usually while hospitalized. This report highlights that even though patients may develop shock and multi-organ failure, there might be no visible signs of bleeding until shortly before death. Methods: This case report describes a 42-year-old male patient with a confirmed diagnosis of CCHF via RT-PCR, who died despite intensive care treatment. Despite receiving intensive care treatment, he did not respond to the septic shock therapy and unfortunately passed away within a few hours. The diagnosis of the disease was made by the reference la­boratory with a positive reverse transcriptase-polymerase chain reaction (RT-PCR) test for CCHF. Results: In this case, the patient exhibited no visible signs of bleeding, such as hematemesis, melena, or gross hematuria, despite being in shock. While CCHF mortality (5–30%) typically occurs during the 3–5-day hemorrhagic phase, this patient died suddenly due to massive intra-abdominal bleeding, skipping the typical bleeding phase. Conclusion: Clinicians should consider that individual differences may be seen in the clinical course of CCHF disease. In addition, the Coronavirus Disease-2019 (COVID-19) pandemic was experienced worldwide when the patient ap­plied. Given the overlapping initial symptoms of COVID-19 and CCHF, clinicians should prioritize differential diagnosis, es-pecially during the COVID-19 pandemic. During the COVID-19 pandemic, diagnostic delays may occur in the manage-ment of CCHF, particularly due to resource allocation.
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spelling doaj-art-64eaf2aebf2d48d98ae485901cfe25102025-08-20T02:30:56ZengTehran University of Medical SciencesJournal of Arthropod-Borne Diseases2322-19842322-22712025-03-0118310.18502/jad.v18i3.18578Fatal Crimean-Congo Hemorrhagic Fever with an Atypical Clinical Course during the COVID-19 PandemicMustafa Arslan0Amasya University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Turkey Background: Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonotic disease characterized by high fever, bleeding manifestations, and a high mortality rate. Most patients begin to experience bleeding 5 to 7 days after the onset of the illness, usually while hospitalized. This report highlights that even though patients may develop shock and multi-organ failure, there might be no visible signs of bleeding until shortly before death. Methods: This case report describes a 42-year-old male patient with a confirmed diagnosis of CCHF via RT-PCR, who died despite intensive care treatment. Despite receiving intensive care treatment, he did not respond to the septic shock therapy and unfortunately passed away within a few hours. The diagnosis of the disease was made by the reference la­boratory with a positive reverse transcriptase-polymerase chain reaction (RT-PCR) test for CCHF. Results: In this case, the patient exhibited no visible signs of bleeding, such as hematemesis, melena, or gross hematuria, despite being in shock. While CCHF mortality (5–30%) typically occurs during the 3–5-day hemorrhagic phase, this patient died suddenly due to massive intra-abdominal bleeding, skipping the typical bleeding phase. Conclusion: Clinicians should consider that individual differences may be seen in the clinical course of CCHF disease. In addition, the Coronavirus Disease-2019 (COVID-19) pandemic was experienced worldwide when the patient ap­plied. Given the overlapping initial symptoms of COVID-19 and CCHF, clinicians should prioritize differential diagnosis, es-pecially during the COVID-19 pandemic. During the COVID-19 pandemic, diagnostic delays may occur in the manage-ment of CCHF, particularly due to resource allocation. https://jad.tums.ac.ir/index.php/jad/article/view/1641Crimean-Congo Hemorrhagic FeverCOVID-19BleedingMortality
spellingShingle Mustafa Arslan
Fatal Crimean-Congo Hemorrhagic Fever with an Atypical Clinical Course during the COVID-19 Pandemic
Journal of Arthropod-Borne Diseases
Crimean-Congo Hemorrhagic Fever
COVID-19
Bleeding
Mortality
title Fatal Crimean-Congo Hemorrhagic Fever with an Atypical Clinical Course during the COVID-19 Pandemic
title_full Fatal Crimean-Congo Hemorrhagic Fever with an Atypical Clinical Course during the COVID-19 Pandemic
title_fullStr Fatal Crimean-Congo Hemorrhagic Fever with an Atypical Clinical Course during the COVID-19 Pandemic
title_full_unstemmed Fatal Crimean-Congo Hemorrhagic Fever with an Atypical Clinical Course during the COVID-19 Pandemic
title_short Fatal Crimean-Congo Hemorrhagic Fever with an Atypical Clinical Course during the COVID-19 Pandemic
title_sort fatal crimean congo hemorrhagic fever with an atypical clinical course during the covid 19 pandemic
topic Crimean-Congo Hemorrhagic Fever
COVID-19
Bleeding
Mortality
url https://jad.tums.ac.ir/index.php/jad/article/view/1641
work_keys_str_mv AT mustafaarslan fatalcrimeancongohemorrhagicfeverwithanatypicalclinicalcourseduringthecovid19pandemic