Use of Routine Laboratory Tests for Diagnosis of Crimean-Congo Hemorrhagic Fever Disease in Emergency Department

Abstract

Introduction: Crimean-Congo hemorrhagic fever (CCHF) is a disease effecting multiple organ systems by microvascular damage and deterioration of hemostasis. Even though the main diagnosis relies on reverse transcriptase-polymerase chain reaction (rt-PCR), it is also known that thrombocytopenia, and/or leukopenia, elevated levels of alanine aminotranferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase (CK) may be determined. In this study, our aim was to analyse the patients hospitalized with suspected CCHF Disease and consequently undergone PCR testing. PCR (+) and PCR (-) patients were compared according to their laboratory results obtained in the Emergency Department (ED). Materials and Methods: In a 2-year period, a total of 150 (female/male: 47/103) patients of any age hospitalized with the suspicion of CCHF were involved into the study. The patients were divided into 2 groups according to their rt-PCR results as PCR (+) (and PCR (-) patients. Two groups were compared according to the laboratory results obtained in the ED. Results: The most common complaint on admission was weakness (n=111, 74%) followed by fever (n=95, 63.3%) and headache (n=16, 10.7%). Ribavirin therapy was administered to 62 patients (41.3%). In 62 patients, PCR test was positive (41.3%). When PCR (+) and PCR (-) groups were compared according to the laboratory results obtained in the ED, number of patients with high AST/ALT, thrombocytopenia, low fibrinogen and aPTT levels were significantly higher in PCR (+) group. Conclusion: The diagnosis of CCHF is a challenging issue which requires high suspicion, particularly in the endemic regions. High AST/ALT, thrombocytopenia, low fibrinogen and aPTT levels determined in the ED should raise the suspect for the possibility of PCR positivity.

Keywords

• Crimean-Congo hemorrhagic fever
• diagnosis
• emergency department

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