A Rapidly Progressive Case of Crimean-Congo Hemorrhagic Fever in Pregnancy Presenting with HELLP-Like Features and Resulting in Maternal and Fetal Death.

Crimean-Congo hemorrhagic fever (CCHF) is a life-threatening viral infection that may mimic hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome during pregnancy. We describe a 30-year-old woman at 23 weeks' gestation who presented with fever, myalgia, thrombocytopenia, and severe transaminase elevation. Initial suspicion of HELLP syndrome was reconsidered in the presence of high fever, rural exposure, and rapidly progressive coagulopathy. Crimean-Congo hemorrhagic fever was confirmed by polymerase chain reaction. Despite intensive supportive therapy and plasmapheresis, fulminant multiorgan failure developed, resulting in maternal and fetal death. This case underscores the need to consider CCHF in febrile pregnant patients with thrombocytopenia in endemic areas.