Tokat ilinde İki İlçe Hastanesinde Kırım-Kongo Kanamalı Ateşi Ön tanısı ile Takipli Olguların Değerlendirilmesi

Abstract

Objective: Tokat is one of the cities in Turkey where Crimean–Congo hemorrhagic fever (CCHF) is endemic. Given that CCHF is fatal and contagious, patients should be isolated and hospitalized. This study aimed to compare the epidemiological, clinical, and laboratory findings of CCHF-positive and CCHF-negative cases in two district hospitals in Tokat. Materials and Methods: Patients applied to Turhal and Zile State Hospitals between January 2018 and December 2019 and had a pre-diagnosis of CCHF were included in this case–control study. The patients’ demographic data, symptoms, treatment, and prognosis were recorded. “Pre-diagnosis for CCHF” was defined as the presence of leukopenia or thrombocytopenia, in addition to the presence of at least two symptoms. Cases had antibodies to CCHF virus or CCHF virus-RNA were defined as “CCHF-positive group” and the others were “CCHF-negative group”. Pearson’s chi-square test and Fisher’s test were used to compare the categorical variables. P values that are less than 0.05 were considered statistically significant. Results: Symptoms of headache (20 vs. 18), nausea and vomiting (20 vs. 16), myalgia (18 vs. 16), and diarrhea (11 vs. 5) were more common in the CCHF-positive group than CCHF-negative group. Leukopenia, thrombocytopenia, elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) levels, and prolongated prothrombin time (PT) and activated partial thromboplastin time (aPTT) levels were also more common. AST elevation and PT prolongation were statistically significant (p=0.01 and p=0.003, respectively). The mortality rate in the CCHF-positive group was 3.8%. Conclusion: Even if there is no history of tick bite in patients living in the endemic region and presenting with headache and gastrointestinal symptoms, CCHF probability is high in the presence of leukopenia, thrombocytopenia, elevated liver enzymes and LDH levels, prolonged PT and aPTT. CCHF should always be considered in patients with these symptoms and laboratory findings.