Ziraman Ipek, Celikbas Aysel, Ergonul Onder, Degirmenci Tulin, Uyanik Sadik Ahmet, Koparal Suha, Dokuzoguz Basak
1 Department of Radiology, Ankara Numune Training and Research Hospital , Ankara, Turkey .
Vector Borne Zoonotic Dis. 2014 Nov;14(11):817-20. doi: 10.1089/vbz.2014.1662.
Crimean-Congo hemorrhagic fever (CCHF) is a fatal viral infection that involves multiple organs, and endothelium. We described abdominal sonographic findings of the patients infected with the Crimean-Congo hemorrhagic fever virus (CCHFV) in relation to the severity of the disease. This is a prospective study performed among hospitalized patients infected with CCHF between 2005 and 2011. A total of 210 hospitalized patients with confirmed CCHF infection were included in the study. The mean age was 47 and 49.5% of the patients were female. Patients were classified as mild, moderate, or severe disease according to their clinical and laboratory findings. The relationship between the clinical severity of CCHF and the abdominal sonographic findings was analyzed. Sonographic findings of abdomen included gallbladder wall thickening (GBWT) in 44 (21%), splenomegaly in 39 (19%), hepatomegaly in 52 (25%), decrease in echo of liver parenchyma in nine (4%), increase in echo liver parenchyma in 13 (6%), intra-abdominal fluid collection/ascites in 23 (11%), and enlarged periportal lymph nodes in seven (3%) cases. GBWT was detected in 3% of mild patients, 23% of moderate patients, and 61% of severe patients (p<0.001). In multivariate analysis to predict the severity, GBWT (odds ratio [OR] 5.4, confidence interval [CI] 1.76-16.49, p=0.003) and intra-abdominal fluid collection/ascites (OR 3.5, CI 1.07-12.61, p=0.049) were found to be significantly associated with disease severity. In conclusion, ultrasonography is a reliable, useful, and noninvasive diagnostic tool for evaluation of the abdominal findings of the patients with CCHFV infection. GBWT and intra-abdominal fluid collection/ascites were found to be predictors of severity.
克里米亚-刚果出血热（CCHF）是一种累及多个器官及内皮的致命性病毒感染。我们描述了感染克里米亚-刚果出血热病毒（CCHFV）患者的腹部超声检查结果与疾病严重程度的关系。这是一项对2005年至2011年间住院的CCHF感染患者进行的前瞻性研究。共有210例确诊为CCHF感染的住院患者纳入研究。患者平均年龄为47岁，49.5%为女性。根据临床和实验室检查结果将患者分为轻症、中症或重症。分析了CCHF临床严重程度与腹部超声检查结果之间的关系。腹部超声检查结果包括44例（21%）胆囊壁增厚（GBWT）、39例（19%）脾肿大、52例（25%）肝肿大、9例（4%）肝实质回声减低、13例（6%）肝实质回声增强、23例（11%）腹腔积液/腹水以及7例（3%）肝门周围淋巴结肿大。GBWT在3%的轻症患者、23%的中症患者和61%的重症患者中被检测到（p<0.001）。在预测严重程度的多因素分析中，发现GBWT（比值比[OR]5.4，置信区间[CI]1.76 - 16.49，p = 0.003）和腹腔积液/腹水（OR 3.5，CI 1.07 - 12.61，p = 0.049）与疾病严重程度显著相关。总之，超声检查是评估CCHFV感染患者腹部表现的可靠、有用且无创性的诊断工具。GBWT和腹腔积液/腹水被发现是严重程度的预测指标。
