Evaluation of Clinical and Hematological Findings of Pediatric Patients With Crimean-Congo Hemorrhagic Fever

Abstract

Background Crimean-Congo hemorrhagic fever (CCHF) is one of the most common viral hemorrhagic fevers. After entering the body, the virus replicates in regional lymph nodes and tissues, then spreads via lymph and monocytes, causing systemic inflammatory response syndrome, septic shock, and disseminated intravascular coagulation (DIC).Methods Sociodemographic, clinical, and hematological data of children (0-18 years) diagnosed with CCHF at the Pediatric Infectious Diseases Clinic of Erzurum Training and Research Hospital between September 2018 and June 2020 were analyzed.Results Of 19 patients, 14 were male and 5 female, with a mean age of 14.2 +/- 3.2 years. Common presenting symptoms included fever, fatigue, and myalgia. Initial lab results showed a white blood cell count of 3012 +/- 1559/mm(3), platelet count of 102.105 +/- 50.350/mm(3), and PT of 17.3 +/- 3.5 seconds. Two patients with persistent fever (>5 days) developed CCHF-associated hemophagocytic syndrome and received intravenous immunoglobulin in addition to ribavirin. Eleven patients with severe thrombocytopenia and/or bleeding received apheresis platelet concentrates; six received fresh frozen plasma.Conclusion CCHF should be considered in patients-regardless of tick exposure-presenting with sudden fever, fatigue, leukopenia, thrombocytopenia, abnormal coagulation, and elevated liver enzymes.