Approach to the Critical Patient

Immediate isolation and infection control

Isolation priority

Hemorrhagic shock and resuscitation

Hemodynamic threats

Resuscitation targets

Antiviral and escalation decisions

Time-critical antiviral initiation

ICU escalation triggers

Mandatory notifications

Monitoring and targets

Monitoring bundle

History

Exposure history

Tick exposure

Animal and occupational exposure

Travel history

Symptom timeline

Four-phase illness progression

Risk factors for mortality

Patient-level mortality predictors

Past medical history

Physical Exam

Vital signs and general

Vital sign pattern

Skin and mucous membrane findings

Haemorrhagic skin signs

Facial and mucosal signs

Abdominal and organ exam

Abdominal findings

Neurologic examination

Tick search

PITFALLS

Clinical pitfalls

Differential Diagnosis

Life-threatening viral hemorrhagic fevers

Other viral hemorrhagic fevers

Hantavirus infection

Non-viral differentials

Bacterial causes

Parasitic differentials

Hematologic and other differentials

Hematologic emergencies

Scrub typhus

Laboratory Tests

Core hematologic labs

Complete blood count

Coagulation panel

Metabolic and organ function

Hepatic panel

Renal function

Inflammatory and additional markers

Virologic and confirmatory tests

RT-PCR

Serology

Lactate

Diagnostic Tests

Scoring Systems

SSI severity scoring index

Swanepoel criteria for severe disease

Viral load as prognostic marker

MRI

MRI head indications

MRI cardiac indications

CT

CT head

CT abdomen and pelvis

CT chest

Ultrasound

Abdominal ultrasound

Cardiac POCUS

Pleural assessment

Disposition

Admission and isolation requirements

All confirmed or suspected CCHF cases require hospital admission

ICU admission indications

Contact tracing and post-exposure prophylaxis

Contact identification

Post-exposure prophylaxis

Discharge criteria

Requirements for discharge

Treatment

Supportive care

Fluid and electrolyte management

Blood product replacement

GI and ulcer prophylaxis

Antiviral therapy

Ribavirin

Drugs to avoid

Adjunctive therapy

Corticosteroids

Intravenous immunoglobulin

Infection control interventions

Environmental decontamination

Staff exposure management

Special Populations

Pregnancy

Pregnancy-specific risks

Treatment modifications in pregnancy

Geriatric

Age-related risk modifications

Treatment considerations in older adults

Pediatrics

Age-specific disease characteristics

Paediatric treatment modifications

Background

Epidemiology

Global distribution

Case demographics

Mortality data

Pathophysiology

Viral entry and replication

Haemorrhagic mechanism

HLH complication

Therapeutic Considerations

Ribavirin evidence base

Corticosteroid rationale

Supportive care primacy

Patient Discharge Instructions

copy discharge instructions

What you had and what to expect

Medications

Warning signs to return to emergency immediately

Preventing tick bites after recovery

Follow-up plan

References

Guidelines and key sources

Systematic reviews and meta-analyses

Landmark cohort and review articles

Infection control and public health

Coding and classification

ICD-10 and diagnostic codes

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.