Original Article

Brucellosis in Patients with Crimean-Congo Hemorrhagic Fever


Background: Crimean-Congo hemorrhagic fever (CCHF) is a fatal zoonotic viral disease caused by infection with a tick-borne virus of the genus Nairovirus. In this study, we investigated the incidence of brucellosis in patients diag­nosed with CCHF.Methods: Overall, 169 patients hospitalized with an initial diagnosis of CCHF were included in 2011 in To­kat/ Turkey. Immunoglobulin M (IgM) antibodies and/or PCR results were used in the laboratory diagnosis of CCHF, while plate and standard tube agglutination (STA) tests were used to diagnose brucellosis.Results: Overall, 120 patients (79%) with positive PCR tests were diagnosed with CCHF. Five (4.16%) were also diag­nosed with brucellosis based on the positive plate and STA test results. Four patients (2.36%) had negative CCHF PCR and positive STA test results.Conclusion: Brucellosis and CCHF can mimic each other and that all patients with CCHF or brucellosis should be screened for both conditions.

Whitehouse CA (2004) Crimean-Congo hemorrhagic fever. Antiviral Res. 64 (3): 145–160.

Deyde VM, Khristova ML, Rollin PE, Ksiazek TG, Nichol ST (2006) Crime-an-Congo hemorrhagic fever virus ge-nomics and global diversity. J Virol. 80(17): 8834–8842.

Schwarz TF, Nsanze H, Longson M, Nitschko H, Gilch S, Shurie H, Ameen A, Zahir AR, Acharya UG, Jager G (1996) Polymerase chain reaction for diagnosis and identification of distinct variants of Crimean-Congo hemor-rhag¬ic fever virus in the United Arab Emir¬ates. Am J Trop Med Hyg. 55(2): 190–196.

Leblebicioglu H (2010) Crimean-Congo haemorrhagic fever in Eurasia. Int J Antimicrob Agents. 36(1): S43–46.

Yilmaz GR, Buzgan T, Torunoglu MA, Safran A, Irmak H, Com S, Uyar Y, Carhan A, Ozkaya E, Ertek M (2008) A preliminary report on Crimean-Con¬go haemorrhagic fever in Turkey, March–June 2008. Euro Surveill. 13(33): 18953.

Dean AS, Crump L, Greter H, Hatten¬dorf J, Schelling E, Zinsstag J (2012) Clini-cal manifestations of human bru-cellosis: a systematic review and me-ta-analysis. PLoS Negl Trop Dis. 6(12): e1929.

Ergonul O, Celikbas A, Baykam N, Eren S, Dokuzoguz B (2006) Analysis of risk-factors among patients with Cri¬mean-Congo haemorrhagic fever virus infec-tion: severity criteria revisited. Clin Microbiol Infect. 12(6): 551–554.

Saijo M, Qing T, Niikura M, Maeda A, Ikegami T, Prehaud C, Kurane I, Mori-kawa S (2002) Recombinant nu¬cle¬o-protein-based enzyme-linked im-muno¬sorbent assay for detection of immu¬noglobulin G antibodies to Cri-mean-Congo hemorrhagic fever virus. J Clin Microbiol. 40(5): 1587–1591.

Alsayed Y, Monem F (2012) Brucellosis laboratory tests in Syria: what are their diagnostic efficacies in different clini¬cal manifestations? J Infect Dev Ctries. 6(6): 495–500.

Marei A, Boghdadi G, Abdel-Hamed N, Hessin R, Abdoel T, Smits H, Fathey F (2011) Laboratory diagnosis of hu¬man brucellosis in Egypt and per¬sis¬tence of the pathogen following treat¬ment. J In¬fect Dev Ctries. 5(11): 786–791.

Young EJ (2005) Brucella species. In: Mandell GL, Bennett JE, Dolin R (Eds). Principles and Practice of Infec¬tious Dis¬eases. 6th. Edition. Elsevier Church¬ill Liv¬ingstone Publishers, pp. 2669–2674.

Solís García del Pozo J, Solera J (2012) Systematic review and meta-analysis of randomized clinical trials in the treat¬ment of human brucellosis. PloS One. 7(2): e32090.

Ciftçi C, Oztürk F, Oztekin A, Karaoğlan H, Saba R, Gültekin M, Mamikoğlu L (2005) Comparison of the serological tests used for the labor¬atory diagnosis of brucellosis. Mikrobiyol Bul. 39(3): 291–299.

Hatipoglu CA, Bulut C, Yetkin MA, Ertem GT, Erdinc FS, Kilic EK, Sari T, Kinikli S, Oral B, Demiroz AP (2010) Evaluation of clinical and la¬boratory predictors of fatality in pa¬tients with Crimean-Congo haemorrhagic fever in a tertiary care hospital in Turkey. Scand J Infect Dis. 42(6–7): 516–521.

Eduardo G, Carlos C (1998) Brucella. In: Sherwood L, Gorbach MD, John G, Barlett MD, Neil R, Blackow MD, edi-tor. Philephia: Wb Saunders Com-pany. pp. 1837–1845.

Ozkurt Z, Kiki I, Erol S, Erdem F, Yil-maz N, Parlak M, Gundogdu M, Tasyaran MA (2006) Crimean-Congo hemorrhag¬ic fever in Eastern Turkey: clinical fea¬tures, risk factors and effi-cacy of rib¬avirin therapy. J Infect. 52(3): 207–215.

Ergonul O (2008) Treatment of Crime¬an-Congo hemorrhagic fever. Antivi¬ral Res. 78(1): 125–31.

Mardani M, Jahromi MK, Naieni KH, Zeinali M (2003) The efficacy of oral ribavirin in the treatment of crimean-congo hemorrhagic fever in Iran. Clin Infect Dis. 36(12): 1613–1618.

Cevik MA, Erbay A, Bodur H, Gülderen E, Baştuğ A, Kubar A, Akinci E (2008) Clinical and laboratory features of Cri¬mean-Congo hemorrhagic fever: pre¬dictors of fatality. Int J Infect Dis. 12 (4): 374–379.

Soares-Weiser K, Thomas S, Thomson G, Garner P (2010) Ribavirin for pa¬tients with Crimean-Congo haemorrhagic fe-ver: a systematic re¬view and meta-anal¬ysis. BMC Infect Dis. 13(10): 207.

Kara SS, Kara D, Fettah A (2016) Vari¬ous clinical conditions can mimic Cri¬mean-Congo hemorrhagic fever in pe¬diatric patients in endemic regions. J Infect Public Health. 9(5): 626–632.

Metin O, Teke TA, Gayretli Aydin ZG, Kaman A, Oz FN, Bayhan GI, Tanir G (2015) A case of brucellosis mimick¬ing Crimean-Congo hemorrhagic fe¬ver. J Infect Public Health. 8(3): 302–304.

Karakeçili F, Çıkman A, Akın H, Gülhan B, Özçiçek A (2016) A case of brucel-losis and Crimean-Congo hemorrhagic fever coinfection in an endemic area. Mikrobiyol Bul. 50(2): 322–327.

IssueVol 11 No 4 (2017) QRcode
SectionOriginal Article
Crimean-Congo hemorrhagic fever Haemorrhagic fever Brucellosis Zoonosis

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How to Cite
Duygu F, Sari T, Kaya T, Bulut N. Brucellosis in Patients with Crimean-Congo Hemorrhagic Fever. J Arthropod Borne Dis. 11(4):463-468.