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DOI: 10.1055/a-2669-8035
Evaluation of Clinical and Hematological Findings of Pediatric Patients with Crimean-Congo Hemorrhagic Fever
Bewertung der klinischen und hämatologischen Befunde von pädiatrischen Patienten mit Krim-Kongo-Hämorrhagischem FieberAuthors
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/mm³, platelet count of 102.105 ± 50.350/mm³, 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.
Zusammenfassung
Hintergrund
Das Krim-Kongo-Hämorrhagische Fieber (CCHF) ist eines der häufigsten viralen hämorrhagischen Fiebersyndrome. Nach Eintritt in den Körper vermehrt sich das Virus in regionalen Lymphknoten und Geweben, verbreitet sich über Lymphgefäße und Monozyten und verursacht ein systemisches Entzündungsreaktionssyndrom, septischen Schock und disseminierte intravaskuläre Gerinnung (DIC).
Methoden
Soziodemografische, klinische und hämatologische Daten von Kindern (0–18 Jahre), die zwischen September 2018 und Juni 2020 in der Klinik für pädiatrische Infektionskrankheiten des Stadtkrankenhaus Erzurum mit CCHF diagnostiziert wurden, wurden analysiert.
Ergebnisse
Von 19 Patienten waren 14 männlich und 5 weiblich, mit einem Durchschnittsalter von 14,2±3,2 Jahren. Häufige Symptome bei Aufnahme waren Fieber, Müdigkeit und Myalgie. Die anfänglichen Laborwerte zeigten eine Leukozytenzahl von 3012±1559/mm³, eine Thrombozytenzahl von 102.105 ± 50.350/mm³ und eine PT von 17,3±3,5 Sekunden. Zwei Patienten mit anhaltendem Fieber (>5 Tage) entwickelten ein CCHF-assoziiertes hämophagozytisches Syndrom und erhielten zusätzlich zur Ribavirintherapie intravenöse Immunglobuline. Elf Patienten mit schwerer Thrombozytopenie und/oder Blutungen erhielten apheresebasierte Thrombozytenkonzentrate, sechs erhielten frisch gefrorenes Plasma.
Schlussfolgerung
CCHF sollte bei Patienten mit plötzlichem Fieber, Müdigkeit, Leukopenie, Thrombozytopenie, abnormalen Gerinnungswerten und erhöhten Leberenzymen – unabhängig von einer Zeckenexposition – in die Differentialdiagnose einbezogen werden.
Publikationsverlauf
Artikel online veröffentlicht:
15. September 2025
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