339. A fatal case of healthcare associated Crimean-Congo haemorrhagic fever with severe disease and multiple complications
Session: Poster Abstract Session: HAI: Outbreaks
Thursday, October 8, 2015
Room: Poster Hall
  • Dr. Mustafa-rev.pdf (857.9 kB)
  • Background: Crimean-Congo haemorrhagic fever (CCHF) is a major emerging infectious disease threat and Turkey is the epicentre of this activity. Healthcare personnel are at risk from occupational infections during patient care and critical care management, associated with increased invasive procedures and the potential for aerosolization in highly viraemic patients poses additional risk. Isolated imported cases of CCHF or outbreaks in countries lacking CCHF experience present particular infection control challenges, and the benefit and evidence for ribavirin or other post-exposure prophylaxis (PEP) options is lacking.

    Methods: Case report: Retrospective analysis of medical records, laboratory results and radiological images.

    Results: We report a case of nosocomial CCHF in a 27 year old emergency medicine resident who sustained a needlestick injury. The source case was initially diagnosed as having sepsis and not suspected as having CCHF. The case presented 3 days after exposure with fever, myalgia, headache and shortness of breath, was CCHF RT-PCR positive and rapidly progressed to severe disease. During the course of the illness, he had numerous complications, including coagulopathy with pulmonary haemorrhage, respiratory failure, encephalopathy and acute renal failure. Despite the use of intensive supportive treatment consisting of early ribavirin use, plasmapharesis, convalescent serum, haemodialysis, ventilation and the use of directed large volume blood product use (94 units FFP, 19 units platelets, 59 units cryoprecipitate) he died on day 11 ofadmission. The cause of death was multi-organ failure with refractory septic shock.

    Conclusion: This case demonstrates the risk of nosocomial CCHF infection and the challenges in the management of severe CCHF. It shows that even with optimal critical care support, CCHF remains a potentially fatal disease and the development of novel therapeutics is required.

    Mustafa Sunbul, Professor, Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey, Saban Esen, Professor, Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey, Tom Fletcher, MD, Liverpool School Tropical Medicine, Liverpool, United Kingdom, Ahmet Dilek, Assoc. Prof., Intensive Care, Ondokuz Mayis University Medical School, Samsun, Turkey, Nil Guler, Assoc. Prof., Hematology, Ondokuz Mayis University Medical School, Samsun, Turkey, Nick J Beeching, MD, Tropical and Infectious Diseases Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom and Hakan Leblebicioglu, Prof., Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey


    M. Sunbul, None

    S. Esen, None

    T. Fletcher, None

    A. Dilek, None

    N. Guler, None

    N. J. Beeching, None

    H. Leblebicioglu, None

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