title: Crimean-Congo hemorrhagic fever: aid of abdominal ultrasonography in prediction of severity.
abstract: Crimean-Congo hemorrhagic fever (CCHF) is a fatal viral infection that involves multiple organs, and endothelium. We described abdominal sonographic findings of the patients infected with the Crimean-Congo hemorrhagic fever virus (CCHFV) in relation to the severity of the disease. This is a prospective study performed among hospitalized patients infected with CCHF between 2005 and 2011. A total of 210 hospitalized patients with confirmed CCHF infection were included in the study. The mean age was 47 and 49.5% of the patients were female. Patients were classified as mild, moderate, or severe disease according to their clinical and laboratory findings. The relationship between the clinical severity of CCHF and the abdominal sonographic findings was analyzed. Sonographic findings of abdomen included gallbladder wall thickening (GBWT) in 44 (21%), splenomegaly in 39 (19%), hepatomegaly in 52 (25%), decrease in echo of liver parenchyma in nine (4%), increase in echo liver parenchyma in 13 (6%), intra-abdominal fluid collection/ascites in 23 (11%), and enlarged periportal lymph nodes in seven (3%) cases. GBWT was detected in 3% of mild patients, 23% of moderate patients, and 61% of severe patients (p<0.001). In multivariate analysis to predict the severity, GBWT (odds ratio [OR] 5.4, confidence interval [CI] 1.76-16.49, p=0.003) and intra-abdominal fluid collection/ascites (OR 3.5, CI 1.07-12.61, p=0.049) were found to be significantly associated with disease severity. In conclusion, ultrasonography is a reliable, useful, and noninvasive diagnostic tool for evaluation of the abdominal findings of the patients with CCHFV infection. GBWT and intra-abdominal fluid collection/ascites were found to be predictors of severity.
authors.affiliation: 1 Department of Radiology, Ankara Numune Training and Research Hospital , Ankara, Turkey .
authors.forename: Ipek
authors.initials: I
authors.lastname: Ziraman
authors.forename: Aysel
authors.initials: A
authors.lastname: Celikbas
authors.forename: Onder
authors.initials: O
authors.lastname: Ergonul
authors.forename: Tulin
authors.initials: T
authors.lastname: Degirmenci
authors.forename: Sadik Ahmet
authors.initials: SA
authors.lastname: Uyanik
authors.forename: Suha
authors.initials: S
authors.lastname: Koparal
authors.forename: Basak
authors.initials: B
authors.lastname: Dokuzoguz
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D005260:Female; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000502:physiology*; D006479:Hemorrhagic Fever, Crimean / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000821:virology; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D014421:Turkey; D014463:Ultrasonography; D055815:Young Adult
keywords: Abdominal ultrasonography; Crimean-Congo hemorrhagic fever; Severity of disease