Abstract
Objective: Infection is the commonest cause of thrombocytopenia. Definite diagnosis helps to manage the patients effectively. The objective was to determine possible infective etiology for fever with thrombocytop-enia and to study the presentation and complications of thrombocytopenia.
Methodology: This prospective study was conducted in Narayana Medical College and Hospital, Nellore between May 2015 – June 2016. 150 patients aged 15 years and above with fever and thrombocytopenia were included for this study. A detailed history, general and systemic examination was done and recorded.
Results: Out of 150 cases of fever with thrombocytopenia, 88(58.7%) were males and 62(41.3%) were females and the most common age group was between 15-30 years 67(44.7%). The most common presentation was fever 150(100%), followed by myalgia 52(34.7%),headache 46(30.7%),cough 24(16%), hepatomegaly 35(23.3%), splenomegaly 26(17.3%) and bleeding manifestations in 18(12%).45(30%) patients had bleeding manifestations of which malena in 18 (40%) was the commonest followed by petechiae/ purpura/ecchymosis in 13(28.8%), hematuria 5(11.1%), epistaxis 3(6.7%),gum bleed 3(6.7%) and hematemesis in 3 (6.7%). Common range of platelet count at the time of admission was in the range of 50000 – 1Lakh/cumm in 72(48%).Infection was the commonest cause of thrombocytopenia and the commonest infection was dengue 68 (45.3%), followed by viral fever other than dengue 22(14.7%), septicemia 19 (12.7%), malaria 17(11.3%), undiagnosed 13(8.7%), enteric fever 9(6%) and leptospirosis 2(1.3%). 140(93.3%) of them had good recovery and 10(6.7%) patients have expired. Of those 10 mortality cases, 6 died due to septicemia,3 due to dengue and 1 had malaria.
Conclusion: Infections, particularly dengue fever was the commonest cause of fever with thrombocytopenia. Majority of the patients with thrombocytopenia are asymptomatic but in significant number of cases there were bleeding manifestations also. Malena was the common bleeding manifestations. On treating the specific cause drastic improvement in platelet count was noted.
Keywords: Fever, Thrombocytopenia, Dengue, Malaria, Platelet count, Mortality.
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DOI: http://dx.doi.org/10.18535/jmscr/v4i9.50
