Two Cases of Hantavirus Infection in Crimean-Congo Haemorrhagic Fever Endemic Region

Abstract

Mustafa Sunbul, Hava Yılmaz, Hasan Çetinkaya, Yavuz Uyar, Dilek Çaglayık, Fatih Bostancı, Hakan Leblebicioglu Crimean-Congo Hemorrhagic Fever (CCHF) and Leptospirosis are endemic in our region. Hantavirus infections may be confused with similar clinical picture zoonotic infections. Two patients with fever, malaise, cough, phlegm, nausea, vom- iting, thrombocytopenia, renal failure, elevated transaminases, and a history of mouse contact were hospitalized in our clinic with a presumptive diagnosis of leptospirosis, pneumonia, CCHF and Hantavirus infections. Empirical antibiotic treatment was initiated and CCHF and leptospirosis was ruled out with laboratory tests. Hantavirus immunoglobulin (Ig)-G and Ig-M antibodies were detected positive by immunoluorescent antibody (IFA) method in both cases but, Dobrova virus was detected in only one patient with immunoblotting methods. Both patients were discharged after treatment. Hantavirus infections may be misdiagnosed as zoonotic infections since they have similar clinical picture. It should be considered in the differential diagnosis of patients with a history of contact with mouse.

Keywords

• -

Two Cases of Hantavirus Infection in Crimean-Congo Haemorrhagic Fever Endemic Region

Öz

Anahtar Kelimeler

• -

References

1. Bi Z, Formenty PB, Roth CE. Hantavirus infection: a review and global update. J Infect Dev Ctries 2008; 2:3-23.
2. Lee HW, Lee PW, Johnson KM. Isolation of the etiologic agent of Korean hemorrhagic fever 1978. J Infect Dis 2004; 190:1711-1721.
3. Leblebicioglu H. Crimean-Congo haemorrhagic fever in Eurasia. Int J Antimicrob Agents 2010; 36:43-46.
4. Ertek M, Buzgan T. An outbreak caused by hantavirus in the Black Sea region of Turkey, January-May 2009. Euro Surveill 2009; 14:1-2.
5. Kaya S, Yilmaz G, Erensoy S, et al. Hantavirus infection: two case reports from a province in the Eastern Blacksea Region, Turkey. Mikrobiyol Bul 2010; 44:479-487.
6. Padula PJ, Edelstein A, Miguel SD, et al.Hantavirus pulmonary syndrome outbreak in Argentina: molecular evidence for person-to-person transmission of Andes virus. Virology 1998; 241:323-330.
7. Laakkonen J, Kallio-Kokko H, Oktem MA, et al. Serological survey for viral pathogens in Turkish rodents. J Wildl Dis 2006; 42:672-676.
8. Koksal I, Yilmaz G, Aksoy F, et al. The efficacy of ribavirin in the treatment of Crimean-Congo hemorrhagic fever in Eastern Black Sea region in Turkey. J Clin Virol 2010; 47:65-68.

9. Peters CJ, Khan AS. Hantavirus pulmonary syndrome: the new American hemorrhagic fever. Clin Infect Dis 2002; 34:1224-1231.