Vaginal bleeding as a sign of Crimean\u2013Congo hemorrhagic fever infection: a case report

Shohra Qaderi,Ahmad Murad Omid,Jalal Sayad,Hossein Hatami

doi:10.1186/s13256-022-03303-z

Abstract

BackgroundCrimean–Congo hemorrhagic fever is a severe vector-borne viral hemorrhagic fever with considerable mortality in humans. This disease is endemic in Afghanistan, and its incidence rate has rapidly increased in recent years. This infection can cause a broad range of hemorrhage manifestations including epistaxis, petechial or purpuric rashes, hematemesis, and melena; however, vaginal bleeding is also reported as a rare manifestation.Case presentationWe report the case of a previously healthy 30-year-old Afghan female of shepherding occupation, with a sudden onset of fever, generalized body pain, epistaxis, and vaginal bleeding. She was admitted to the hospital after 7 days of symptom manifestation, with predominant signs being high fever, vaginal bleeding, and elevated liver enzymes. The serological test result for Crimean–Congo hemorrhagic fever was positive. She was treated with oral ribavirin and discharged with normal parameters.ConclusionsPeople in high-risk professions in endemic areas should be informed that vaginal bleeding is a serious symptom and requires immediate action and, therefore, might be attributed to nongynecologic disorders.

Highlights

Crimean–Congo hemorrhagic fever (CCHF), is an acute, severe vector-borne viral hemorrhagic fever with considerable mortality in humans
People in high-risk professions in endemic areas should be informed that vaginal bleeding is a serious symptom and requires immediate action and, might be attributed to nongynecologic disorders
Human CCHF is characterized by a sudden onset of fever, headache, dizziness, nausea, weakness, irritability, and severe limb and loin pain, which has shown a wide range of severity, from mild, nonspecific febrile illness to shock and death

Summary

Introduction

Crimean–Congo hemorrhagic fever (CCHF), is an acute, severe vector-borne viral hemorrhagic fever with considerable mortality in humans. Case presentation On the evening of 5 May 2018 (T = 0), a non-Kabul resident, 30-year-old Afghan single female was admitted to Kabul Antani Hospital because of fever, pain, hemorrhage (petechia, epistaxis, and uterine bleeding), and vomiting. One day later (T = 3), she presented epistaxis and vaginal bleeding [last menstrual period (LMP) was on 20 April]. She was brought to the hospital and admitted to the CCHF ward of Kabul Antani Hospital. She denied history of travel, tick bite, and sick contacts; she had no prior medical conditions or medication use. Mg/dl: Milligram Per Decilitre β We obtained indirect bilirubin via total bilirubin − direct bilirubin are not normally followed up in governmental hospitals of Afghanistan, information about her condition after discharge was not available

Discussion

Conclusion