title: Fatal outcome of coinfection of Crimean-Congo hemorrhagic fever and malaria.
abstract: Here, we report a case of a Bulgarian patient with imported falciparum malaria that manifested 6 days after his arrival in Bulgaria, which was complicated by bloody diarrhea 2 days later. Blood smear revealed high parasitemia, with annular forms and gametocytes of Plasmodium falciparum. In addition, RNA of the Crimean-Congo hemorrhagic fever (CCHF) virus was detected in the blood sample by real-time reverse transcription (RT)-PCR and nested RT-PCR. The obtained sequence was found to be clustered within the Europe 1 lineage close to the other Bulgarian strains. Notably, the two infectious diseases may appear with many similar symptoms that are difficult to distinguish.
authors.affiliation: Department of Microbiology, National Center of Infectious and Parasitic Diseases.
authors.forename: Iva
authors.initials: I
authors.lastname: Christova
authors.forename: Andrei
authors.initials: A
authors.lastname: Petrov
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
authors.forename: Dimitar
authors.initials: D
authors.lastname: Vutchev
authors.forename: Nikolay
authors.initials: N
authors.lastname: Kalvatchev
authors.forename: Nikolay
authors.initials: N
authors.lastname: Vatev
authors.forename: Mariana
authors.initials: M
authors.lastname: Stoycheva
mesh_terms: D000328:Adult; D001769:Blood / Q000469:parasitology / Q000821:virology; D002031:Bulgaria; D060085:Coinfection / Q000469:parasitology / Q000473:pathology* / Q000821:virology; D017809:Fatal Outcome; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000302:isolation & purification; D006479:Hemorrhagic Fever, Crimean / Q000150:complications* / Q000473:pathology / Q000821:virology; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000469:parasitology / Q000473:pathology; D008297:Male; D008853:Microscopy; D008969:Molecular Sequence Data; D010963:Plasmodium falciparum / Q000302:isolation & purification; D012367:RNA, Viral / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA
chemical_list: D012367:RNA, Viral