Resting Heart Rate in Children with Crimean–Congo Hemorrhagic Fever: A Tool to Identify Patients at Risk?

Myocarditis in a Child with Crimean-Congo Hemorrhagic Fever

Crimean-Congo hemorrhagic fever (CCHF) is a viral, tick-borne disease that can be fatal, especially in the adult patient population. CCHF involves multiple organ systems. Pericardial effusion, cardiac hypokinesia, T-wave changes, bundle branch block, and myocardial involvement can be seen as a cardiac complication of CCHF. Several different viruses like Coxsackie A/B and adenovirus may cause myocarditis and cardiomyopathy, but myocardial involvement of CCHF in children was rarely reported. We report a 13-year-old boy patient with myocarditis during the course of CCHF who has completely resolved after convalescent period of the disease.

Transient sinus bradycardia during the course of Crimean-Congo hemorrhagic fever in children

Crimean-Congo hemorrhagic fever (CCHF) is an acute tick-borne viral zoonotic disease which is endemic in Turkey. Bradycardia has been reported among pediatric and adult patients with CCHF. But, it remains unclear, whether bradycardia is associated with ribavirin treatment or the severity of CCHF. In this study 26 hospitalized CCHF patients were reviewed in terms of age, gender, history of tick bite, duration of hospitalization, presence of bradycardia, laboratory features, ribavirin treatment, and blood products requirement. The demographic, clinical, laboratory and treatment characteristics of CCHF patients with or without bradycardia were compared. The mean age of the patients was 126.42±48.21 months. There were 8 female and 18 male patients. Sinus bradycardia was noted in 15 patients (mean age was 120.20±50.59 months, 5 female). Ribavirin had been administered 18 (69.2%) patients and 11 of them had bradycardia. There was not statistically significant relationships between bradycardia and ribavirin treatment (p=0.683). Furthermore the occurrence of bradycardia was not associated with disease severity according to Swanepoel severity criteria (p=0.683). We concluded that independent of the disease severity and the ribavirin treatment, transient sinus bradycardia might occur during the clinical course of CCHF in pediatric patients. For this reason clinicians should be aware of this finding and all CCHF patients should be monitored closely.