Şükran KÖSE, Filiz OĞUZ, Sabri ATALAY, Selma GÜL

KIRIM-KONGO KANAMALI ATEŞİ: İKİ OLGU SUNUMU

Kırım-Kongo Kanamalı Ateşi, viral hemorajik ateş sendromları arasında yer alan zoonotik bir enfeksiyondur. İnsanlar çoğunlukla kenelerin ısırmasıyla, hastalığın akut safhasında hasta ile temas ya da viremik hayvanların kan ve dokularına temas yoluyla enfekte olurlar. Olgu 1 Kırsal alanda yaşayan altmış yaşındaki kadın hasta, yüksek ateş, baş ağrısı, burun kanaması, üç gün boyunca olan kas ağrısı şikayetleri ile acil servise başvurdu. Hastaya Kırım-Kongo Kanamalı ateş tanısı kondu. Ribavirin tedavisi başlanan hasta tam iyileşme sonrası taburcu edildi. Olgu 2 Otuz dokuz yaşında bir erkek sekiz gün boyunca diş eti kanaması halsizlik, boğaz ağrısı şikayetleri, genel vücut ağrısı, beş gün önce bir tıp merkezine başvurmuş. Laboratuvar test sonuçları bisitopeni ve karaciğer fonksiyon testleri yüksek seviyelerde gösterdi. Destekleyici tedavi veya antiviral tedavi uygulanmadı. Yüksek ateş geriledi ve karaciğer fonksiyon testleri yedinci günden itibaren normale döndü ve hasta tam iyileşme ile hastaneden taburcu edildi. Kırım-Kongo Kanamalı Ateşi, Türkiye’de endemik bir hastalıktır. Erken tanı ve destekleyici tedavi önemlidir.

Anahtar Kelimeler:

hemorajik ateş, zoonoz, Bunyaviridae

CRIMEAN-CONGO HEMORRHAGIC FEVER: REPORT OF TWO CASES

Crimean-Congo hemorrhagic fever is a zoonotic infection and it is one of viral hemorrhagic fever syndromes. Humans usually become infected by bites of ticks, contact with a patient in the acute phase of the disease or contact with the blood or tissues of viremic livestock. Case Report 1 A sixty year old female patient living in rural areas was admitted to the emergency service with the complaints of high fever, headache, epistaxis, generalized myalgia for three days. The patient was diagnosed with Crimean-Congo hemorrhagic fever and was hospitalized in the infectious diseases ward. The patient who received ribavirin therapy was discharged from the hospital after a full recovery. Case Report 2 A thirty nine year old male had applied to a medical center five days ago with the complaints of weakness, sore throat, generalized body pain, bleeding gums for eight days. Laboratory test results showed bicytopenia and high levels of liver function tests. The patient was diagnosed with Crimean-Congo hemorrhagic fever and was hospitalized in the infectious diseases ward. Neither supportive treatment nor antiviral treatment was administered to the patient. The high fever resolved and liver function tests returned to the normal values from the seventh day and the patient was discharged from the hospital after making a full recovery. Crimean-Congo Hemorrhagic Fever is a endemic disesase in Turkey. Early diagnosis and supportive treatment are crucial.

Keywords:

hemorrhagic fever, zoonosis, Bunyaviridae,

PDF

___

) Swanepoel R, Gill DE, Shepherd AJ, Leman PA, Mynhardt JH et al. The clinical pathology of Crimean- Congo hemorrhagic fever. Rev Infect Dis.1989;11(supp ): 794-800.
) Khan AS, Maupin GO, Rollin PE, Noor AM, Shurie HH et al. An outbreak of Crimean-Congo hemorrhagic fever in the United Arab Emirates. Am J Trop Med Hyg.1997;519
) Mehrabi-Tavana A, Chinicar S, Mazaheri V. The seroepidemiological aspects of Crimean-Congo haemorrhagic fever in three health workers: a report from Iran. Arch Iranian Med 2002; 5: 255-8.
) Gozalan A, Akin L, Rolain JM, Tapar FS, Oncül O et al. Epidemiological evaluation of a possible outbreak in and nearby Tokat province. Mikrobiyol Bul 2004; 38: 33-44.
) Peters CJ, Zaki SR. Role of the endothelium in viral hemorrhagic fevers. Crit Care Med. 2002; 30(supp 5): 73.
) Bausch DG, Ksiazek TG. Viral hemorrhagic fevers including hantavirus pulmonary syndrome in the Americas. Clin Lab Med. 2002; 22(4): 981-1020.
) Ergonul O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis 2006; 6(4); 203-14.
)Gear JHS. What is Crimean Congo Haemorrhagic Fever? SAMJ, 1982; 62: 570-80.
) Watts DM, Ussery MA, Nash D, Peters CJ. Inhibition of Crimean-Congo hemorrhagic fever viral infectivity yields in vitro by ribavirin. Am J Trop Med Hyg 1989; 41(5): 581-5.
) Bakir M, Ugurlu M, Dokuzoguz B, Bodur H, Tasyaran MA, Vahaboglu H. Crimean-Congo hemorrhagic fever outbreak in Middle Anatolia: a multicentre study of clinical features and outcome measures. J Med Microbiol 2005; (Pt4): 385-9.