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.
T. Fletcher, None
A. Dilek, None
N. Guler, None
N. J. Beeching, None
H. Leblebicioglu, None