When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Last reviewed: 21 Mar 2025
Last updated: 28 Jun 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • myalgia
  • malaise
  • bleeding
  • macular or petechial rash

Other diagnostic factors

  • headache
  • nausea
  • abdominal pain
  • hepatomegaly
  • splenomegaly
  • somnolence
  • diarrhoea
  • hypotension
  • conjunctivitis
  • arthralgia

Risk factors

  • residency in or recent travel to CCHF-endemic region
  • history of tick exposure
  • contact with infected body fluids
  • occupational exposure
  • contact with infected animals
  • unprotected sexual contact with an infected individual

Diagnostic investigations

1st investigations to order

  • reverse transcription-polymerase chain reaction (RT-PCR)
  • malaria investigations

Investigations to consider

  • serology
  • FBC
  • coagulation studies
  • LFTs
  • serum creatinine and urea
  • urinalysis
  • serum electrolytes
  • lactate dehydrogenase
  • creatine phosphokinase

Treatment algorithm

Contributors

Authors

Maryam Keshtkar Jahromi, MD, MPH, FIDSA

Assistant Professor of Medicine

Division of Infectious Diseases

Johns Hopkins University School of Medicine

Baltimore

MD

Disclosures

MKJ declares that she has no competing interests.

Mohammad Fereidouni, MD

Postdoctoral Research Fellow

Division of Infectious Diseases

Johns Hopkins University School of Medicine

Baltimore

MD

Disclosures

MF declares that he has no competing interests.

Acknowledgements

Dr Maryam Keshtkar Jahromi and Dr Mohammad Fereidouni would like to gratefully acknowledge Dr Onder Ergonul, a previous contributor to this topic.

Disclosures

OE is the author of references cited in this topic.

Peer reviewers

John S. Schieffelin, MD

Associate Professor of Pediatrics

Adjunct Associate Professor of Medicine

Sections of Pediatric & Adult Infectious Diseases

Tulane University School of Medicine

New Orleans

LA

Disclosures

JSS declares that he has no competing interests.

Vanessa Raabe, MD, MSc

Adult and Pediatric Infectious Disease Fellow

Emory University

Atlanta

GA

Disclosures

VR declares that she has no competing interests.

Tom Fletcher, MBChB, MRCP, DTM&H

Wellcome Trust/MoD Research Fellow

Liverpool School of Tropical Medicine

Liverpool

UK

Disclosures

TF receives Crimean-Congo haemorrhagic fever research funding from the Wellcome Trust and UK Surgeon General. He is a member of the WHO secretariat for Crimean-Congo haemorrhagic fever guideline development.

Ayşe Erbay, MD, MPH

Professor of Infectious Diseases

Faculty of Medicine

Bozok University

Yozgat

Turkey

Disclosures

AE declares that she has no competing interests.

Use of this content is subject to our disclaimer