«Masks» of Crimean hemorrhagic fever in medical practice


DOI: https://dx.doi.org/10.18565/epidem.2024.14.2.87-93

Abuova G.N., Pshenichnaya N.Yu., Lizinfeld I.A., Berdalieva F.A., Sadykhova D.K., Bukharbaev E.B.

1) South Kazakhstan Medical Academy, Shymkent, Kazakhstan; 2) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 3) M.F. Vladimirsky Moscow Regional Research Clinical Institute named after., Moscow, Russia
The severity and outcomes of Crimean hemorrhagic fever (CHF) depend on the timeliness of diagnosis and hospitalization in an infectious diseases hospital. Delay in diagnosis and initiation of specific treatment is an important risk factor for poor outcome.
Objective. Analysis of defects in the diagnosis of CHF and development on this basis of a differential diagnostic algorithm with an assessment of its effectiveness.
Materials and methods. A retrospective longitudinal study analyzed 94 laboratory-confirmed cases of CHF in patients who were admitted in infectious diseases hospitals in the Turkestan region and the city of Shymkent for 2011–2023.
Results. Difficulties in making a diagnosis of CHF were associated with the nonspecificity of symptoms at the initial stage of the disease, incomplete collection of anamnesis and epidemiological data, limited knowledge of medical personnel about the disease and the criteria for its diagnosis, and underestimation of the severity of the patient’s condition. Infectious, surgical, therapeutic and gynecological «masks» of CHF were established, and relevant clinical observations were presented. Analysis of cases of delayed diagnosis of CHF became the basis for the development of a differential diagnostic algorithm for this disease.
Conclusion. In natural foci of CHF, it is important for doctors of different professions to be vigilant, have up-to-date knowledge and apply modern diagnostic methods to reduce the likelihood of diagnostic errors when identifying CHF. Algorithms for the differential diagnosis of CHF created and applied in the training of medical workers led to a significant reduction in the proportion of cases of underestimation of CHF by 3.6 times and allowed to avoid delays in starting etiotropic and pathogenetic therapy.
Keywords: differential diagnostic algorithm, diagnostic defects, hemorrhagic syndrome, Crimean hemorrhagic fever, thrombocytopenia
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About the Autors

Professor Gulzhan N. Abuova, Cand. Med. Sci., Head; Department of Infectious Diseases and Dermatovenerology, South Kazakhstan Medical Academy, Shymkent, Kazakhstan; dr.abuova@gmail.com; https://orcid.org/0000-0002-1210-2018
Professor Natalia Yu. Pshenichnaya, MD, Deputy Director for Сlinical and Analytical Work, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Professor, Department of Infectious Diseases, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia; natalia-pshenichnaya@yandex.ru; https://orcid.org/0000-0003-2570-711X
Irina A. Lizinfeld, Cand. Med. Sci., Consultant, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; irinalizinfeld@gmail.com; https://orcid.org/0000-0002-8114-1002
Farida A. Berdalieva, PhD, Associate Professor, Department of Infectious Diseases and Dermatovenereology, South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan; fberdalieva@mail.ru; https://orcid.org/0000-0001-96801678
Dana K. Sadykhova, Assistant, Department of Infectious Diseases and Dermatovenereology, South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan; danoka.kz@mail.ru
Erkin B. Buharbayev, Assistant, Department of Infectious Diseases and Dermatovenereology, South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan; kz__erkin@mail.ru; https://orcid.org/0000-0003-2089-5393


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