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Crimean Congo hemorrhagic fever infection simulating acute appendicitis

Aysel Celikbaş1, Onder Ergönül, Başak Dokuzoğuz

  • 1First Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.

The Journal of Infection
|April 23, 2005
PubMed

Insights

Crimean-Congo hemorrhagic fever (CCHF) can present with abdominal pain mimicking appendicitis. This case highlights intramuscular hemorrhage as an unusual CCHF manifestation, requiring careful diagnosis.

Area of Science:

  • Infectious Diseases
  • Virology
  • Clinical Medicine

Background:

  • Crimeyan-Congo hemorrhagic fever virus (CCHFV) infection is a severe tick-borne viral illness.
  • CCHF typically presents with fever, myalgia, and hemorrhagic manifestations.
  • Abdominal pain can occur, but unusual presentations require thorough investigation.

Observation:

  • A patient presented with symptoms including fever, malaise, headache, nausea, vomiting, diarrhea, and severe bleeding.
  • Initial diagnosis suspected Crimean-Congo hemorrhagic fever virus infection, with ribavirin therapy initiated.
  • During recovery, the patient developed acute right lower quadrant abdominal pain.

Findings:

  • Exploratory laparotomy revealed intramuscular hemorrhage in the abdominal wall.
  • Confirmation of Crimean-Congo hemorrhagic fever virus infection was established via positive CCHF IgM antibodies.
  • This indicates an unusual manifestation of CCHF presenting as acute abdominal pain.

Implications:

  • Highlights the diverse clinical spectrum of CCHF, extending beyond typical hemorrhagic symptoms.
  • Emphasizes the importance of considering CCHF in patients with severe febrile illness and unusual abdominal presentations.
  • Suggests that intramuscular hemorrhage should be recognized as a potential complication of CCHF, impacting surgical and diagnostic decisions.

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