A case of invasive pulmonary aspergillosis in a patient diagnosed with Crimean-Congo Hemorrhagic Fever

Year 2024, Volume: 29 Issue: 1, 89 - 93, 27.01.2024

Enes Telli , Sinan Çetin , Haldun Öner , Beyza Yüksel , Emsal Aydın

https://doi.org/10.21673/anadoluklin.1298492

Abstract

Crimean-Congo hemorrhagic fever (CCHF) is endemic around Kelkit valley in our country. It is a zoonotic disease characterized by fever, headache, abdominal pain, nausea-vomiting, myalgia, and bleeding. Invasive pulmonary aspergillosis (IPA) is frequently seen in the presence of risk factors such as prolonged neutropenia, transplantation, hematological-solid malignancies, immunosuppressive treatments, and has a high mortality rate. The case presented in this report is a patient with a definitive diagnosis of CCHF who received dexamethasone treatment due to a severe disease course with profound cytopenias. After short-term corticosteroid treatment, IPA developed in the early period, and the patient died. Our case is remarkable in terms of IPA development in the course of CCHF, and to our knowledge, it is the first case report of this association in the literature. Aspergillus infections can be seen without classical immunosuppressive risk factors. Effective use of microbiological, serological and imaging methods are important in terms of early diagnosis of cases and early initiation of antifungal treatment. Aspergillus infections should always be kept in mind in critically ill patients followed in the intensive care unit.

Keywords

Aspergillosis, hemoragic fever virus, invasive pulmonary aspergillosis

Project Number

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Kırım-Kongo Kanamalı Ateşi tanısı alan hastada gelişen invaziv pulmoner aspergilloz olgusu

Abstract

Kırım-Kongo kanamalı ateşi (KKKA), ülkemizde Kelkit vadisi ve çevresinde endemiktir. Ateş yüksekliği, baş ağrısı, karın ağrısı, bulantı-kusma, miyalji ve kanamalarla seyreden bir zoonotik hastalıktır. İnvaziv pulmoner aspergilloz (IPA), sıklıkla uzamış nötropeni, transplantasyon, hematolojik-solid malignite, immunosupresif tedaviler gibi risk faktörleri varlığında görülür ve yüksek mortaliteyle seyretmektedir. Bu bildiride sunulan olgu KKKA kesin tanısı alan ve derin sitopenilerle şiddetli hastalık seyri göstermesi üzerine deksametazon tedavisi almıştır. Kısa süreli kortikosteroid tedavisi sonrası erken dönemde IPA gelişmiş ve hasta kaybedilmiştir. Olgumuz KKKA seyrinde IPA gelişmesi açısından dikkat çekicidir ve bildiğimiz kadarıyla literatürde bu birlikteliğe ait ilk vaka bildirimidir. Aspergillus enfeksiyonları klasik immunosupresif risk faktörleri dışında da görülebilmektedir. Olguların erken tanı alması ve antifungal tedaviye erken başlanması açısından mikrobiyolojik, serolojik ve görüntüleme yöntemlerinin etkin kullanılması önemlidir. Kritik hastalığı olup yoğun bakım ünitesinde takip edilen olgularda Aspergillus enfeksiyonları her zaman akılda tutulmalıdır.

Keywords

Aspergillozis, hemorajik ateş virüsü, invaziv pulmoner aspergilloz

Supporting Institution

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Project Number

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Thanks

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