[ co- infection of crime Congo hemorrhagic fever and brucellosis: a case report]

ABSTRACT

Crimean-Congo Hemorrhagic fever [CCHF] is a viral disease transmitted to ruminants or human by the bite of mature tick vectors. It can be transmitted through contact with the infectious blood or viraemic tissues during slaughter and hospital contacts. 80% of the cases are sub clinical and the rest of them are presenting with an acute febrile and occasionally hemorrhagic disease. The mortality rate of the fulminate form of the disease is equal to 20% to 50%. The hemorrhage is usually in the form of hematoma, melena, nose, conjunctiva, uterine or subcutaneous bleeding. CCHF complications are encephalitis, optic neuropathy, hepatitis, renal failure and myocardial necrosis. In this article, we've discussed a CCHF patient who presented with high fever, myalgia, headache, nausea, vomiting, abdominal pain, diffuse cutaneous and gingival hemorrhage during the course of the disease while the patient was hospitalized. Profound jaundice, petechia and global ecchymosis were considerable. Lab data showed at the beginning of hospitalization that the number of liver enzymes was increased up to 8-10 times. The number of placates were lower than 150000 ml. Moreover, during the first three days there was a decrease in the number of white blood cells and PTT was abnormal. [AST] was higher than 100 units per litre. The results of serologic examination of IgM- ELISA virus for CCHF on day 5 and IgG-ELISA on day 10-which were carried out in pasture Institute-were reported to be positive. According to the patient's history and clinical symptoms, he was also suspicious for Brucellosis and the lab data demonstrated that he is also infected with Brucella. [Wright=1.320, 2ME=1.160] The patient was a 22 year old man, sheep farmer, residing in the GhalehKamkar area of Qom City