DefinePK

Research Objective

To share the experience of managing Crimean-Congo Hemorrhagic Fever (CCHF) cases at a tertiary care hospital.

Methodology

Hospital-based case series conducted at the Medicine department of Combined Military Hospital Peshawar from 2017 to 2019. Ten RT-PCR positive CCHF cases were included retrospectively. Cases with negative PCR, multiple co-morbidities, or alternative diagnoses were excluded. Demographic, epidemiological, clinical, and laboratory parameters were collected. Data analysis was performed using SPSS-22.

Methodology Flowchart

                        graph TD;
    A["Identify CCHF Cases"] --> B["Collect Retrospective Data"];
    B --> C["Apply Inclusion/Exclusion Criteria"];
    C -- Included --> D["Record Demographic, Clinical, Lab Data"];
    D --> E["Analyze Data using SPSS-22"];
    E --> F["Interpret Findings"];
    F --> G["Formulate Conclusion"];                    

Discussion

CCHF is an endemic zoonotic disease transmitted by ticks, posing a risk to individuals in endemic areas, particularly soldiers. The study observed typical CCHF symptoms like fever, body ache, and bleeding tendencies. Laboratory findings of leukopenia and thrombocytopenia were consistent with previous studies. While ribavirin and platelet transfusions were administered, the role of ribavirin in hastening recovery requires further investigation, as some patients recovered without it. Oral Vitamin C was used as a supportive measure for vascular endothelial protection.

Key Findings

All ten patients were male armed forces personnel employed in tribal areas of KPK. Initial symptoms included fever and generalized body pains in all patients. Two patients developed petechial rash, and one experienced epistaxis, melena, and hematuria. Laboratory findings showed leukopenia, thrombocytopenia, and elevated ALT and LDH in all patients. All patients recovered completely. 80% received ribavirin and platelet transfusion, and all received oral Vitamin C. Average hospital stay was 14 days.

Conclusion

Crimean-Congo Hemorrhagic Fever is a potentially fatal disease, with individuals visiting endemic areas, such as soldiers, being at particular risk. Key manifestations include fever, petechial rash, and thrombocytopenia. Treatment is primarily supportive. The potential benefits of oral Vitamin C supplements and ribavirin in accelerating recovery warrant further high-power studies and should be considered for suspected and confirmed cases.

Fact Check

* The study included 10 RT-PCR positive cases of CCHF. (Confirmed in Methodology and Results)
* All patients were males and armed forces personnel employed in tribal areas of KPK. (Confirmed in Results)
* 80% of the patients received ribavirin and platelet transfusion. (Confirmed in Results)

Mind Map