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J Med Microbiol 56 (2007), 1126-1128; DOI: 10.1099/jmm.0.46910-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Case Report

Haemophagocytosis in a patient with Crimean–Congo haemorrhagic fever

Atahan Cagatay1, Mahir Kapmaz1, Asli Karadeniz1, Seniha Basaran1, Mustafa Yenerel2, Selim Yavuz2, Kenan Midilli3, Halit Ozsut1, Haluk Eraksoy1 and Semra Calangu1

1 Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

2 Department of Internal Medicine, Division of Hematology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

3 Department of Microbiology and Clinical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey

Correspondence
Atahan Cagatay
atayon{at}yahoo.com

Received 22 August 2006
Accepted 7 May 2007

Crimean–Congo haemorrhagic fever (CCHF) is a severe disease with a case fatality of 2.8 to 80 %. A patient dwelling in an endemic region for CCHF was admitted with fever preceding bleeding diathesis and pancytopenia. Despite no history of tick exposure, CCHF was highly suspected. With an oral ribavirin therapy, clinical and laboratory improvements were obtained. The diagnosis was confirmed by detection of IgM antibody to CCHF virus and positive RT-PCR. Although the main pathogenesis of CCHF infection is not elucidated yet, haemophagocytosis, a symptom rarely reported in viral haemorrhagic fevers, was observed in this case. Haemophagocytosis is suggested to have a role in the development of pancytopenia in CCHF, the mechanism of which still needs to be investigated, probably with cytokine studies. Together with clinical symptoms and patient history, haemophagocytosis may be an indicator for CCHF.

Abbreviations: CCHF, Crimean–Congo haemorrhagic fever.






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