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Crimean-Congo hemorrhagic fever: A pediatric case responding to plasmapheresis treatment
Oktay Perk1, Serhat Emeksiz1, Serhan Ozcan1
1Division of Pediatric Intensive Care, Department of Pediatrics, Ankara City Hospital, Ankara, Turkey.
Insights
Crimean-Congo hemorrhagic fever (CCHF) is a severe tick-borne illness. This case study shows plasmapheresis combined with ribavirin effectively treated a critically ill infant with CCHF and multi-organ failure.
Area of Science:
- Infectious Diseases
- Pediatrics
- Hematology
Background:
- Crimean-Congo hemorrhagic fever (CCHF) is a severe, tick-borne viral illness with high mortality.
- Supportive care and ribavirin are standard treatments, but severe cases may require advanced interventions.
- Pediatric intensive care unit (PICU) management for CCHF is critical in cases of multi-organ failure.
Observation:
- A seven-month-old infant presented with CCHF symptoms including fever, epistaxis, cough, vomiting, and weakness.
- The infant developed multi-organ failure, characterized by thrombocytopenia and acute liver failure.
- A family history of CCHF-related deaths indicated a high-risk presentation.
Findings:
- The infant received three sessions of plasmapheresis in addition to ribavirin therapy.
- Clinical condition and laboratory values significantly improved by the sixth day of PICU admission.
- The patient was transferred to the infectious diseases service in stable condition.
Implications:
- Plasmapheresis may be a crucial adjunctive therapy for severe pediatric CCHF with multi-organ failure.
- Early and aggressive intervention, including plasmapheresis, can improve outcomes in critically ill CCHF patients.
- This case highlights the potential benefit of plasmapheresis in managing life-threatening CCHF in infants.
Abstract:
Crimean-Congo hemorrhagic fever (CCHF) is a life-threatening tick-borne viral infection. The most important step in the treatment of CCHF is supportive therapy. Ribavirin is the recommended antiviral agent for infected patients. We present a case of a child who presented to our pediatric intensive care unit due to CCHF and was treated with plasmapheresis and ribavirin. A previously healthy seven-month-old male infant presented to the emergency room with a fever of 39.5 °C, nosebleed, cough, vomiting, and weakness. We decided to apply plasmapheresis treatment due to multiple organ failure associated with thrombocytopenia, acute liver failure, and a family history of death from the disease. Plasmapheresis was performed in three sessions. By the sixth day of his admission to the intensive care unit, the patient's clinical condition had improved and his laboratory values had returned to normal, so he was transferred to the infectious diseases service in stable condition.
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