Title: Clinical Profile of Mortality due to fever with Thrombocytopenia during an Epidemic

Authors: Dr Lijo K Mathew, Dr Jayachandran. R

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i3.166

Abstract

Introduction: Many of the acute infective diseases which present as febrile thrombocytopenia during an epidemic have overlapping clinical profile and many of them may not have a definite diagnosis even at the time of patients’ mortality. However it is very important for the treating physician to have some clues from the patients’ clinical details to help in initial management of each patient. This can be achieved only by studying the profile of patients who died in hospital due to an acute infective episode. Hence this study was carried out to demonstrate the clinical profile of such patients and to correlate with their final diagnosis.

Objective: To study the clinical profile of patients who presented with febrile thrombocytopenia and had a fatal end during hospital stay.

Materials and Methods: All patients who presented with fever and thrombocytopenia and had mortality during hospital stay during the study period of five months starting with monsoon were selected for the study. Their clinical profile was analyzed and the results are presented as descriptive data.

Results: Among the 45 patients who were screened for the study, 26 were included and studied. Symptoms present in more than 50% of the patients were body pain, breathlessness and bleeding episodes. The only clinical sign found to be altered significantly in majority was tachypnea and abnormal investigations were altered liver and renal functions. About half of patients belonged to acute undifferentiated fever, 38% were dengue infection and 12% were leptospirosis.

Conclusions: Even during an epidemic, the causes of febrile thrombocytopenia are varied and each patient requires individualized treatment plan. There is a need to formulate mortality indicators in patients with febrile thrombocytopenia.

Keywords: Febrile thrombocytopenia, mortality indicators, epidemic.

References

  1. South-East Asia Regional Office. (2018). Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Hemorrhagic Fever. [online] Available at: http://www.searo.who.int/entity/vector_borne_tropical_diseases/documents/SEAROTPS60/en/ [Accessed 17 Mar. 2018].
  2. Leptospirosis | National Health Portal of India [Internet]. Nhp.gov.in. 2018 [cited 17 March 2018]. Available from: https://www.nhp.gov.in/disease/leptospirosis
  3. Rahi M, Gupte M, Bhargava A, Varghese G, Arora R. DHR-ICMR Guidelines for Diagnosis and Management of Rickettsial Diseases in India. 2018.
  4. Naveen Kulkarni, Venkatesh Moger: A clinical study of febrile thrombocytopenia at a Tertiary Care Hospital in North Karnataka, International Journal of Biomedical Research 2017; 8(01): 15-19.
  5. Praveen Kumar, Kalpana Chandra: A Clinical Study of Febrile Thrombocy-topenia: A Hospital-based Retrospective Study, Indian Journal of Clinical Practice, Vol. 24, No. 10, March 2014
  6. P Gondhali, Manoj Vethekar: Clinical assessment of fever with thrombocytopenia - A prospective study, International Journal of Medical Research & Health Sciences, 2016, 5, 1:258-277
  7. Sing-Sin Sam, Sharifah Faridah Syed Omar: Review of Dengue Hemorrhagic Fever Fatal Cases Seen among Adults: A Retrospective Study PLOS Neglected Tropical Diseases May 2013 | Volume 7 | Issue 5 | e2194
  8. Modi T, , Amit D. Mehta: Clinical Profile of Febrile Thrombocytopenia: A Hospital-Based Cross Sectional Study, Journal of Research in Medical and Dental Science | Vol. 4 | Issue 2 | April – June 2016

Corresponding Author

Dr Jayachandran. R

Assistant Professor, Department of Medicine,

Govt. T.D. Medical College, Alappuzha

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