Haemophagocytosis in a patient with Crimean Congo haemorrhagic fever.
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.
Cagatay
Atahan
A
Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Kapmaz
Mahir
M
Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Karadeniz
Asli
A
Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Basaran
Seniha
S
Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Yenerel
Mustafa
M
Department of Internal Medicine, Division of Hematology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Yavuz
Selim
S
Department of Internal Medicine, Division of Hematology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Midilli
Kenan
K
Department of Microbiology and Clinical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Ozsut
Halit
H
Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Eraksoy
Haluk
H
Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Calangu
Semra
S
Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
D000328:Adult; D015415:Biomarkers; D001792:Blood Platelets / Q000276:immunology; D001853:Bone Marrow / Q000503:physiopathology*; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000472:pathogenicity*; D006479:Hemorrhagic Fever, Crimean / Q000276:immunology / Q000503:physiopathology*; D006644:Histiocytes / Q000276:immunology*; D006801:Humans; D009504:Neutrophils / Q000276:immunology; D010587:Phagocytosis
D015415:Biomarkers