Fatal Outcome of Coinfection of Crimean-Congo Hemorrhagic Fever and Malaria

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  • Christova Iva
    Department of Microbiology, National Center of Infectious and Parasitic Diseases
  • Petrov Andrei
    Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Plovdiv
  • Papa Anna
    Department of Microbiology, Medical School, Aristotle University of Thessaloniki
  • Vutchev Dimitar
    Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Plovdiv
  • Kalvatchev Nikolay
    Department of Microbiology, National Center of Infectious and Parasitic Diseases
  • Vatev Nikolay
    Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Plovdiv
  • Stoycheva Mariana
    Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Plovdiv

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Here, we report a case of a Bulgarian patient with imported falciparum malaria that manifested 6 days after his arrival in Bulgaria, which was complicated by bloody diarrhea 2 days later. Blood smear revealed high parasitemia, with annular forms and gametocytes of Plasmodium falciparum. In addition, RNA of the Crimean-Congo hemorrhagic fever (CCHF) virus was detected in the blood sample by real-time reverse transcription (RT)-PCR and nested RT-PCR. The obtained sequence was found to be clustered within the Europe 1 lineage close to the other Bulgarian strains. Notably, the two infectious diseases may appear with many similar symptoms that are difficult to distinguish.

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