risk factors associated with poor prognosis in children with crimean-congo hemorrhagic fever

background crimean-congo hemorrhagic fever (cchf) was a rare disease in iran before 1999. during the last 15 years, it has been reported from different provinces of iran, mostly from southeastern iran. objectives this study aimed to evaluate the factors associated with poor outcome in children and adolescents with cchf. patients and methods we studied all files of children (age < 19 years old) with cchf who were admitted to our hospital in zahedan from september 1999 to october 2012. evaluated factors in association with the prognosis included aspartate transaminase (ast), alanine transaminase (alt), activated partial thromboplastin time (aptt), prothrombin time (pt), platelet count, and hemorrhagic diathesis. results we evaluated 39 children and adolescents (mean age, 12.9 ± 4.2 years) with cchf. among them, nine patients (23%) died. the risk factors associated with poor prognosis were platelet count < 50000, pt > 15 seconds, aptt > 45 seconds, the presence of hemorrhagic diathesis, alt and ast more than five-time the upper limit of normal, loss of consciousness, and myocarditis. conclusion the most important factor associated with mortality was a platelet count < 50000 at the admission time. more investigations on the efficacy of drugs such as steroid and specific immunoglobulin in treatment of patients with risk factors such as severe thrombocytopenia are needed.