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Volume 27, Number 4—April 2021
Dispatch

Fatal Case of Crimean-Congo Hemorrhagic Fever Caused by Reassortant Virus, Spain, 2018

Anabel NegredoComments to Author , Rafael Sánchez-Arroyo, Francisco Díez-Fuertes, Fernando de Ory, Marco Antonio Budiño, Ana Vázquez, Ángeles Garcinuño, Lourdes Hernández, César de la Hoz González, Almudena Gutiérrez-Arroyo, Carmen Grande, and Paz Sánchez-Seco
Author affiliations: National Center of Microbiology, Madrid, Spain (A. Negredo, F. Díez-Fuertes, F. De Ory, A. Vázquez, L. Hernández, P. Sánchez-Seco); Complejo Asistencial de Ávila, Ávila, Spain (R. Sánchez-Arroyo, M.A. Budiño, A. Garcinuño, C. de la Hoz González, C. Grande); CIBERESP, Madrid (A. Vázquez); La Paz Hospital, Madrid (A. Gutiérrez-Arroyo)

Main Article

Table 1

Serial hematologic and biochemical parameters, vital signs, and treatments administered for Crimean-Congo hemorrhagic fever patient, Spain, 2018*

Variable Jul 31 Aug 4 Aug 5 Aug 6 Aug 7
Hematologic parameters
Hemoglobin, g/dL 13.5 14.5 12.9 12.4 9.4
Hematocrit, % 39.4 42.9 37.7 36.4 28
Leukocytes, × 10−3 cells/mm3 10.7 4.1 3.6 4.6 5.9
Neutrophils, × 10−3 cells/mm3 9.5 2.7 2.4 2.8 3.6
Lymphocytes, × 10−3 cells/mm3 0.4 0.9 0.8 1.1 1.3
Platelets, × 10−3/mm3 229 19 12 16 71
Internal normalized ratio 0.97 0.91 0.94 NT 1.27
Prothrombin time, s 10.7 9.9 10.2 NT 14
Prothrombin activity, % 104 115 110 NT 71
Partial thromboplastin time, s 26.2 46.7 47.5 NT Not coagulable
Functional fibrinogen, mg/dL 320 274 268 NT 172
D-dimer, ng/mL
 NT
 NT
 1123
 NT
 1781
Biochemical parameters
Aspartate aminotransferase, U/L 20 197 527 961 3,129
Alanine aminotransferase, U/L 9 52 155 269 755
Bilirubin, mg/dL 0.5 0.6 0.5 0.7 0.9
Gamma-glutamyl transferase, U/L 22 229 303 388 545
Alkaline phosphatase, U/L 43 187 289 456 679
Lactate dehydrogenase, U/L 172 1,017 1,188 1,801 3,864
Creatinine, mg/dL 0.83 0.6 0.96 0.8 0.77
Sodium, mmol/L 138 136 134 134 137
Potassium, mmol/L 4.3 5.4 4.5 4.5 4.9
Ionic calcium, mmol/L 1.1 NT 1.15 1.06 1.06
Albumin, g/dL 3.9 NT 2.8 2.4 2.3
Glucose, mg/dL 83 87 97 100 117
Uric acid, mg/dL NT NT NT 3.7 NT
C-reactive protein, mg/dL 0.51 1.77 3.77 NT
Procalcitonin, ng/L 0.17 0.22 0.63 NT NT
Bicarbonate, mmol/L 23.2 NT 21.6 20.8 20
Lactate, mmol/L 1.1 3 1.4 1.2 2.5
Ferritin, ng/dL NT NT NT >40,000 NT
Ammonia, μmol/L NT NT NT NT 60
Spontaneous urine protein, g/L Neg 1.41 NT NT NT
Erythrocytes in urine, cells/μg
 Neg
 50
 NT
 NT
 NT
Vital signs
Temperature, °C 39.2 38.3 37.1 37.2 37.1
Blood pressure, mm Hg 122/59 116/66 110/65 100/60 90/45
Heart rate, beats/min
 110
 87
 70
 76
 89
Treatments received, IV
Physiologic serum N Y Y Y Y
Doxycycline N Y Y Y Y
Piperacillin–tazobactam N Y Y Y Y
Levofloxacin N Y N N Y
Platelets, 1 pool N Y N N Y
Vitamin K N N N N Y
Tranexamic acid N Y N N Y
Fresh frozen plasma N N N N Y
Methylprednisolone N Y Y Y Y

*IV, intravenous; neg, negative; N, not collected/administered that day; NT, not tested, Y, yes, collected/administered that day.

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Page created: February 09, 2021
Page updated: March 18, 2021
Page reviewed: March 18, 2021
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