Vaginal bleeding as a sign of Crimean-Congo hemorrhagic fever infection: a case report

Background Crimean-Congo hemorrhagic fever is a severe vector-borne viral hemorrhagic fever with considerable mortality in humans. This disease is endemic in Afghanistan, and its incidence rate has rapidly increased in recent years. This infection can cause a broad range of hemorrhage manifestations including epistaxis, petechial or purpuric rashes, hematemesis, and melena; however, vaginal bleeding is also reported as a rare manifestation. Case presentation We report the case of a previously healthy 30-year-old Afghan female of shepherding occupation, with a sudden onset of fever, generalized body pain, epistaxis, and vaginal bleeding. She was admitted to the hospital after 7 days of symptom manifestation, with predominant signs being high fever, vaginal bleeding, and elevated liver enzymes. The serological test result for Crimean-Congo hemorrhagic fever was positive. She was treated with oral ribavirin and discharged with normal parameters. Conclusions People in high-risk professions in endemic areas should be informed that vaginal bleeding is a serious symptom and requires immediate action and, therefore, might be attributed to nongynecologic disorders.

Automated summary

Crimean-Congo hemorrhagic fever is a severe viral hemorrhagic fever with high mortality. This case report describes a previously healthy Afghan female with shepherding occupation who presented with fever, body pain, epistaxis, and vaginal bleeding. She was diagnosed with Crimean-Congo hemorrhagic fever and successfully treated with ribavirin.