title: Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever.
abstract: OBJECTIVE
  Crimean-Congo hemorrhagic fever (CCHF) is a fatal disease, caused by a tick-borne virus (Nairovirus), having a high mortality rate. The study was aimed to evaluate the risk factors, the presenting symptoms and findings of the patients with prediagnosis of CCHF disease, and to compare these variables between the CCHF-positive and CCHF-negative patients. It was also aimed to develop a scoring formula for the diagnosis of CCHF.
  
  
  METHODS
  In total, 281 patients who were admitted to the Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey between 2011 and 2015 and were prediagnosed with CCHF based on the clinical symptoms, laboratory findings and risk factors were included in the study. The definitive laboratory diagnosis of patients with prediagnosis of CCHF was ensured via molecular and serological methods. In addition, a mathematical diagnostic scoring formula was developed for enhancing the laboratory results of CCHF.
  
  
  RESULTS
  The ratio of certain clinical symptoms such as fever (p<0.001), headache (p<0.001), widespread body pain (p<0.001), fatigue (p = 0.001), nausea and vomiting (p = 0.013) in CCHF-positive patients were found to be significantly higher compared to the ratio in CCHF-negative patients. In terms of laboratory findings such as presence of leucopenia (p<0.001), creatine kinase (CK) elevation (p<0.001), thrombocytopenia (p<0.001), aspartate aminotransferase/alanine aminotransferase (AST/ALT) elevation (p<0.001), lactate dehydrogenase (LDH) levels (p = 0.002), absence of abnormal findings on chest radiograph (p = 0.042), and the absence of anaemia (p = 0.007), the CCHF-positive patients had higher rates in comparison to CCHF-negative ones.
  
  
  CONCLUSIONS
  It was inferred that certain clinical symptoms and laboratory findings such as fever, headache, widespread body pain, fatigue, leucopenia, nausea, vomiting, high CK levels, thrombocytopenia, AST/ ALT elevation and elevated LDH levels are highly specific and are required to be considered in the definitive diagnosis of CCHF, particularly in regions where this infection is observed as endemic.
authors.affiliation: Department of Microbiology, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya University, Amasya, Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Kilinc
authors.affiliation: Department of Microbiology, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya University, Amasya, Turkey.
authors.forename: Ridvan
authors.initials: R
authors.lastname: Gückan
authors.affiliation: Department of Internal Medicine, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya University, Amasya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Capraz
authors.affiliation: Department of Radiology, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya University, Amasya, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Varol
authors.affiliation: Amasya Institute of Public Health, Amasya, Turkey.
authors.forename: Erman
authors.initials: E
authors.lastname: Zengin
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Mengeloglu
authors.affiliation: Laboratory of Biochemistry Department, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya University, Amasya, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Menekse
mesh_terms: D000328:Adult; D000368:Aged; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003661:Decision Support Techniques; D005260:Female; D006479:Hemorrhagic Fever, Crimean / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult