Clinical Management and Laboratory Test Utilization in Pediatric Tick Bite Presentations in a Crimean-Congo Hemorrhagic Fever Endemic Region

Objective: Routine laboratory test requesting is not recommended for every child presenting with a tick bite; however, the factors influencing laboratory test requesting in daily pediatric practice remain poorly understood. This study aimed to evaluate the clinical management of pediatric tick bites and to identify demographic and temporal factors associated with laboratory test requesting. Methods: This retrospective, single-centre, cross-sectional study included children aged 0–18 years presenting with tick bites to a tertiary referral hospital between January 2022 and December 2024. Demographic characteristics, management, laboratory investigations, and clinical outcomes were analyzed. Independent factors associated with laboratory test requesting were evaluated using multivariable logistic regression including variables available before the laboratory test requesting decision. Consistent with the predefined study objective, the analysis focused on demographic and temporal factors associated with laboratory test requesting; clinical variables, including presenting symptoms and physical examination findings, were not included in the analysis. Results: A total of 631 patients were included (mean age, 7.87±4.92 years; 52.1% female). Laboratory investigations were performed in 262 patients (41.5%), whereas 369 (58.5%) were managed without laboratory testing. Hospitalization was required in 1.1% of cases, there were no CCHF diagnoses, and no mortality. Younger age (odds ratio [OR] = 0.951, 95% confidence interval [CI]: 0.918–0.985; p = 0.006), presentation in 2024 versus 2022 (OR = 1.833, 95% CI: 1.232–2.726; p = 0.003), and presentation during spring versus summer (OR = 2.264, 95% CI: 1.429–3.587; p < 0.001) were independently associated with laboratory test ordering, whereas winter presentation was associated with lower odds of testing (OR = 0.051, 95% CI: 0.007 – 0.381; p = 0.004). Sex was not independently associated with laboratory test ordering. Conclusion: In this cohort, most children were managed without laboratory testing or hospital admission, and no documented CCHF diagnosis or death was identified in the available institutional records.