title: A case of Crimean-Congo hemorrhagic fever complicated with acute pancreatitis.
abstract: BACKGROUND
  Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease characterized by nonspecific symptoms like fever, myalgia, severe headache, nausea, vomiting, diarrhea, and abdominal pain. It can result in various complications during the course of the disease due to the diffuse endothelial injury involved in the pathogenesis of CCHF.
  
  
  OBJECTIVE
  Here we present a patient with CCHF complicated by acute pancreatitis, including pleural and intra-abdominal effusions.
  
  
  METHODS
  A 70-year-old patient was referred to our hospital from an endemic area with the suspicion of CCHF. The physical examination of the patient revealed high fever (38°C), somnolence, and petechial eruption. The diagnosis of case was confirmed with positive reverse transcriptase polymerase chain reaction (RT-PCR). The viral load of the patient was 4×10(9) copies/mL. On the fifth day of admission, upper abdominal pain, scleral ichter, and abdominal distention developed. The patient had abdominal tenderness with guarding. The laboratory tests revealed an amylase level of 1740 U/L (28-100), lipase level of 583 U/L (13-60), and total bilirubin level of 3.75 mg/dL (<0.3). The diagnosis of acute pancreatitis was confirmed with radiological findings.
  
  
  CONCLUSIONS
  Until now, atypical presentations of CCHF have been reported in some case reports, but not acute pancreatitis. To the best of our knowledge, this is the first case of acute pancreatitis in the literature seen in the course of CCHF.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Training and Research Hospital , Ankara, Turkey .
authors.forename: Aliye
authors.initials: A
authors.lastname: Bastug
authors.forename: Bircan
authors.initials: B
authors.lastname: Kayaaslan
authors.forename: Ayse
authors.initials: A
authors.lastname: But
authors.forename: Halide
authors.initials: H
authors.lastname: Aslaner
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sertcelik
authors.forename: Esragul
authors.initials: E
authors.lastname: Akinci
authors.forename: Pinar
authors.initials: P
authors.lastname: Onguru
authors.forename: Meltem Arzu
authors.initials: MA
authors.lastname: Yetkin
authors.forename: Hurrem
authors.initials: H
authors.lastname: Bodur
mesh_terms: D000368:Aged; D005260:Female; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000235:genetics / Q000302:isolation & purification*; D006479:Hemorrhagic Fever, Crimean / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis; D019562:Viral Load
keywords: Crimean-Congo hemorrhagic fever virus (CCHFV); Disease symptoms; Vector-borne