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Crimean-Congo haemorrhagic fever (CCHF) and brucellosis are widely seen zoonotic diseases in Turkey. Their common clinical manifestations include fever, headache, fatigue, nausea, vomiting and diarrhea. Bleedings and creatine kinase (CK) elevation can be seen in CCHF. Laboratory findings of both diseases are leukopenia, thrombocytopenia, alanine aminotranferase (ALT), aspartate aminotranferase (AST), lactate dehydrogenase (LDH) elevation and activated partial thromboplastin time (aPTT) prolongation. We presented a 46-year-old male shepherd to emphasize that co-infection is possible. Ten days ago, when one of his goats died, he cut it and gave it to the dogs as food. Three days later, he had fever, chills, and fatigue. On the 5th day, a watery diarrhea was added. On the 7th day of the symptoms, he was admitted to the emergency department with increased fatigue, decreased oral intake and tendency to sleep. He had no history of tick bite, but he lived in the endemic region for CCHF, his general condition was good and he had no fever. Physical examination was unremarkable. White blood cell count was 3600/mm3, platelet count was 9000/mm3, ALT was 1871 U/L, AST was 7626 U/L, LDH was 9283 U/L, CK was 516 U/L, aPTT was 100.4 seconds, and creatinine (Cr) was 1.8 mg/dL. Brucella serum tube agglutination was positive at 1/20 dilution; Brucella immunocapture agglutination was positive at a titer of 1/320. CCHF polymerase chain reaction and CCHF IgM antibodies were positive. He was given intravenous immune globulin for 5 days, and went through platelet and fresh frozen plasma replacement. During follow-up, no fever or bleeding was observed. Cr levels decreased. He was discharged on the 12th day of hospitalization, and rifampin and doxycycline treatment was completed in six weeks. Considering that our country is endemic for both brucellosis and CCHF, it is important to include both infections in the differential diagnosis.
Klimik Dergisi 2019; 32(3): 341-3.
Cite this article as: Tahmaz A, Deniz M, Günay V, Öztoprak N. [Coinfection of Crimean-Congo haemorrhagic fever and brucellosis: A case report]. Klimik Derg. 2019; 32(3): 341-3. Turkish.