Volume 7, Issue 1 And 2 (1-2019)                   JoMMID 2019, 7(1 And 2): 1-5 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Heydari A A. Acute Complicated Brucellosis Mimicking Crimean-Congo Hemorrhagic Fever (CCHF) and Vice Versa. JoMMID 2019; 7 (1 and 2) :1-5
URL: http://jommid.pasteur.ac.ir/article-1-189-en.html
Department of Infectious Diseases and Research Center for Infection Control and Hand Hygiene, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract:   (3914 Views)
Brucellosis and Crimean Congo Hemorrhagic Fever (CCHF) are both common zoonoses that may co-occur in similar epidemiological conditions, e.g., among young livestock breeders, veterinarians, and farmers in rural areas. Transmission of Brucella bacteria is through ingestion of contaminated dairy products, while CCHF virus infection occurs via infective tick bite or exposure of damaged skin and mucosa to the tissues and blood of viremic animals. Brucellosis occurs almost in all seasons, while CCHF is of lower incidence in the cold seasons due to decreased activity of tick vectors. CCHF mimics brucellosis and vice versa, mainly when the latter manifests severe thrombocytopenia and hemorrhage. Occasionally, the two illnesses present similar clinical features and laboratory results, e.g., fever, muscle aches, increased liver enzymes, and thrombocytopenia. This article discusses the similar clinical, epidemiological and laboratory aspects of the two diseases and warns physicians to avoid the inappropriate use of drugs such as ribavirin, which is dangerous in patients with kidney failure and pregnancy.
Full-Text [PDF 350 kb]   (1431 Downloads)    
Type of Study: Review article | Subject: Infectious diseases and public health
Received: 2019/04/17 | Accepted: 2019/07/20 | Published: 2019/11/3

References
1. 1. Duygu F, Sari T, Kaya T, Nermin Bulut. Brucellosis in Patients with Crimean-Congo Hemorrhagic Fever. J Arthropod Borne Dis. 2017; 11 (4): 463-468.
2. Heydari AA, Ahmadi F, Sarvghad MR, Safari H, Bajouri A, Saeidpour M. Hemophagocytosis and pulmonary involvement in brucellosis. Int J Infect Dis. 2007; 11: 89-90. [DOI:10.1016/j.ijid.2006.01.003]
3. Metin O, Teke TA, Gayretli Aydin ZG, Kaman A, Oz FN, Bayhan GI, et al. A case of brucellosis mimicking Crimean-Congo hemorrhagic fever. J Infect Public Health. 2015; 8: 302-304. [DOI:10.1016/j.jiph.2014.09.008]
4. Al Mousa AI. Epistaxis as the initial manifestation of brucellosis. Int J Health Sci (Qassim). 2008; 2: 157-162.
5. Al-Eissa YA, Kambal AM, Al-Nasser MN, Al-Habib SA, Al-Fawaz IM, Al-Zamil FA.Childhood brucellosis: A study of 102 cases. Ped Infect Dis.1990; 9: 74-79. [DOI:10.1097/00006454-199002000-00002]
6. Crosby E, Llosa L, Miro Quesada M, Carrillo C, Gotuzzo E. Hematologic changes in brucellosis. J Infect Dis. 1984; 150: 419-424. [DOI:10.1093/infdis/150.3.419]
7. Kilinc C, Gückan R, Capraz M, Varol K, Zengin E, Mengeloglu Z, Menekse E.J Vector Borne Dis. .Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever. 2016; 53(2): 162-7
8. Gwida M, Al Dahouk S, Melzer F, Rösler U, Neubauer H, Tomaso H. Brucellosis regionally emerging zoonotic disease? Croat Med J 2010; 51(4): 289-95 [DOI:10.3325/cmj.2010.51.289]
9. Gwida M, Al Dahouk S, Melzer F, Rösler U, Neubauer H, Tomaso H. Brucellosis - regionally emerging zoonotic disease? Croat Med J. 2010; 51(4): 289-95. [DOI:10.3325/cmj.2010.51.289]
10. Ashford DA, di Pietra J, Lingappa J, Woods C, Noll H, Neville B, et al. Adverse events in humans associated with accidental exposure to the livestock brucellosis vaccine RB51. Vaccine. 2004 3; 22 (25-26): 3435-9. [DOI:10.1016/j.vaccine.2004.02.041]
11. Akinci E, Bodur H, Sunbul M, Leblebicioglu H. "Prognostic factors, pathophysiology and novel biomarkers in Crimean-Congo hemorrhagic fever" Antiviral research 2016; 132: 233-243. [DOI:10.1016/j.antiviral.2016.06.011]
12. Sharififard M, Alavi SM, Salmanzadeh S, Safdari F, Kamali A. Epidemiological Survey of CrimeanCongo Hemorrhagic Fever (CCHF), Fatal Infectious Disease in Khuzestan Province, Southwest Iran, During 1999 - 2015. Jundishapur J Microbiol. 2016; 9 (5). [DOI:10.5812/jjm.30883]
13. da Silva, Rodrigo Lopes. "Viral-associated thrombotic microangiopathies" Hematology/oncology and stem cell therapy 2011; 4 (2): 51-59. [DOI:10.5144/1658-3876.2011.51]
14. Ergonul, Onder. "Crimean-Congo hemorrhagic fever virus: new outbreaks, new discoveries." Current opinion in virology 2012; 2 (2): 215-220. [DOI:10.1016/j.coviro.2012.03.001]
15. Guler, Nil, Eroglu C, Yilmaz H, Karadag A, Alacam H, Sunbul M. et al. "Apoptosis-Related Gene Expression in an Adult Cohort with Crimean-Congo Hemorrhagic Fever" PloS one. 2016; 11 (6): e0157247. [DOI:10.1371/journal.pone.0157247]
16. S. K. Al-Tikriti, F. Al-Ani, F. J. Jurji, H. Tantawi, M. Al-Moslih, N. Al-Janabi, , et.al. Congo/Crimean haemorrhagic fever in Iraq Bull World Health Organ. 1981; 59 (1): 85-90
17. Guzel Tunccan O, Dizbay M, Senol E, Aki Z, Ozdemir K. Isolated Severe Immune Thrombocytopenia due to Acute Brucellosis. Indian J Hematol Blood Transfus. 2014; 30: 27-29. [DOI:10.1007/s12288-012-0222-3]
18. Al Mousa AI. Epistaxis as the initial manifestation of brucellosis. Int J Health Sci (Qassim). 2008; 2: 157-162.
19. de Stoppelaar SF, van 't Veer C, Claushuis TA, Albersen BJ, Roelofs JJ, van der Poll T.Thrombocytopenia impairs host defense in gram-negative pneumonia-derived sepsis in mice. Blood. 2014; 124: 3781-3790. [DOI:10.1182/blood-2014-05-573915]
20. McCuskey RS, Urbaschek R, Urbaschek B. The microcirculation during endotoxemia. Cardiovasc Res. 1996; 32: 752-763. [DOI:10.1016/S0008-6363(96)00113-7]
21. Baldane S, Sivgin S, Alkan TS, Kurnaz F, Pala C, Keklik M, Karaman A, Kaynar L. An atypical presentation of brucellosis in a patient with isolated thrombocytopenia complicated with upper gastrointestinal tract bleeding. Case Rep Med. 2012; 2012: 473784. [DOI:10.1155/2012/473784]
22. García P, Yrivarren JL, Argumans C, Crosby E, Carrillo C, Gotuzzo E. Evaluation of the bone marrow in patients with brucellosis. Clinico-pathological correlation. Enferm Infecc Microbiol Clin. 1990; 8: 19-24.
23. Demir C, Karahocagil MK, Esen R, Atmaca M, Gönüllü H, Akdeniz H. Bone marrow biopsy findings in brucellosis patients with hematologic abnormalities. Chin Med J (Engl). 2012; 125: 1871-1876.
24. George MR. Hemophagocytic lymphohistiocytosis: Review of etiologies and management.J Blood Med. 2014; 69-86. [DOI:10.2147/JBM.S46255]
25. Yildirmak Y, Palanduz A, Telhan L, Arapoglu M, Kayaalp N. Bone marrow hypoplasia during Brucella infection. J Pediatr Hematol Oncol. 2003; 25: 63-4. [DOI:10.1097/00043426-200301000-00012]
26. Pappas G, Kitsanou M, Christou L, TsianosE. Immune thrombocytopenia attributed to brucellosis and other mechanisms of Brucella-induced thrombocytopenia. Am J Hematol. 2004; 75: 139-141. [DOI:10.1002/ajh.10473]
27. Yrivarren JL, Lopez LR. Cryoglobulinemia and cutaneous vasculitiesin human brucellosis.J Clin Immunol. 1987; 7: 471-474. [DOI:10.1007/BF00915057]
28. Bastug A, Kayaaslan B, Kazancioglu S, Aslaner H, But A, Akinci E, et al. Crimean-Congo Hemorrhagic Fever: Prognostic Factors and the Association of Leukocyte Counts with Mortality. Jpn J Infect Dis. 2016; 69 (1): 51-5. [DOI:10.7883/yoken.JJID.2014.566]
29. Kilinc C, Gückan R, Capraz M, Varol K, Zengin E, Mengeloglu Z,et.al.J Vector Borne Dis. Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever. 2016; 53 (2): 162-7.
30. H. Cem and Erdem H. Brucellosis (Brucella Species).in Mandell, Douglas, and Bennett's Principles and practice of Infectious Diseases.Pub.Elsevier, 2015, 8 Ed. Chapter 228, Vol. 2, 2585-2589
31. Akıncı E, Bodur H, Erbay C, Cevik MA, Erbay A, Colpan A. A case of brucellosis presenting with severe thrombocytopenia. Turk J Hematol. 2003; 20: 43-45.
32. Young EJ, Tarry A, Genta RM, Ayden N, Gotuzzo E. Thrombocytopenic purpura associated with brucellosis: Report of 2 cases and literature review. Clin Infect Dis. 2000; 31: 904-909. [DOI:10.1086/318129]
33. Altuntas F, Eser B, Sari I, Yildiz O, Cetin M, UnalA. Severe thrombotic microangiopathy associated with brucellosis: Successful treatment with plasmapheresis. Clin Appl Thromb Hemost. 2005; 11: 105-108. [DOI:10.1177/107602960501100114]
34. Madkour MM. Madkour's brucellosis. 2nd ed. New York: Springer-Verlag; 2001. 33-37 [DOI:10.1007/978-3-642-59533-2_4]
35. Turunc T, Demiroglu YZ, Kizilkilic E, Aliskan H, Boga C, Arslan H. A case of disseminated intravascular coagulation caused by Brucella melitensis. J Thromb Thrombolysis. 2008; 26: 71-73. [DOI:10.1007/s11239-007-0065-1]
36. Schrezenmeier H, Müller H, Gunsilius E, Heimpel H, Seifried E. Anticoagulant-inducedpseudothrombocytopenia and pseudoleucocytosis. Thromb Haemost. 1995; 73: 506-513. [DOI:10.1055/s-0038-1653805]
37. Sevinc A, Buyukberber N, Camci C, Buyukberber S, Karsligil T. Thrombocytopenia in brucellosis: Case report and literature review. J Natl Med Assoc. 2005; 97: 290-293.
38. Köksal I, Yilmaz G, Iskender S, Arslan M, Yavuz I, Aksoy F. The first Crimean-Congohemorrhagic fever case in the winter season from Turkey. Vatansever ZIntervirology. 2011; 54: 144-145. [DOI:10.1159/000319432]
39. Mourya DT, Viswanathan R, Jadhav SK, Yadav PD, Basu A, Chadha MS . Retrospective analysis of clinical information in Crimean-Congo haemorrhagic fever patients: 2014-2015, India Indian J Med Res. 2017; 145 (5): 673-678.

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.