DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20200255

Clinical, etiological and laboratory profile of febrile thrombocytopenia and correlation of platelet count with outcome in a South Indian tertiary hospital

Mahesh Kakanale, Manoj A. G., Prabhakar K., Raveesha A.

Abstract


Background: Febrile thrombocytopenia is commonly encountered by doctors especially during monsoon and peri-monsoon period, many of these patients have a turbulent cthisse with multi organ dysfunction and might land up in ICU with significant morbidity and mortality. Infections are the commonest causes of thrombocytopenia and they vary with season and geographical location. A systematic approach, carried out with an awareness of causes, clinical presentation and laboratory profile of febrile thrombocytopenia can shorten the duration of investigations and bring out the diagnosis early, reducing morbidity and mortality of patients and reducing burden on hospital resthisces. The objective of the study is to study the underlying etiology, the various clinical presentations, laboratory profile and complications of fever with thrombocytopenia in this community during monsoon period and to correlate thrombocytopenia with outcome, co morbidities and its etiology.

Methods: The prospective observational study was conducted in tertiary centre in Kolar between June-December 2017. Patients meeting inclusion and exclusion criteria were grouped into 4 groups based on platelet counts, and correlated with comorbidities, etiology and outcome. Detailed clinical and laboratory examination were done in all patients and p value of <0.05 was considered statistically significant.

Results: Among 465 patients were included in the study. Dengue was the most common cause for febrile thrombocytopenia and mortality. Hepatic complications and petechiaes were the most common complications and bleeding manifestations. 135 patients received platelet transfusion but there was no relationship between platelet transfusion and outcome, there were 9 deaths in the study and there was no association between death and platelet count at admission.

Conclusions: There was no relation between platelet count on admission and mortality and also there was no relationship between platelet transfusion and outcome. Knowing the clinical presentation, etiology, complications and its monitoring can significantly reduce the morbidity and mortality due to febrile thrombocytopenia.


Keywords


Dengue, Febrile thrombocytopenia, Fever, Mortality, Outcome, Profile, Thrombocytopenia

Full Text:

PDF

References


Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's principles of internal medicine, 20th Ed New York: McGraw Hill Education; 2018.

Sekhon S, Roy V. Thrombocytopenia in Adults: A Practical Approach to Evaluation and Management. South Med J. 2006;99(5):491-8.

Singhi S, Chaudhary D, Varghese GM. Tropical fever management guidelines. Indian J Crit care Med. 2014;18(2):62-9.

Agarwal M, Rodgers GM. Miscellaneous causes of thrombocytopenia In: Greer JP, Arber DA, Glader B eds. Wintrobe’s Clinical Hematology 13th Ed.; 2014:1097-1105.

Kumbhar SS, Kanetkar SR, Mane AM. A Study of clinical and laboratory profile of patients having fever with thrombocytopenia and its outcome. Indian J of Basic Applied Med Res. 2017;6(2):282-9.

Anand N, Talib SH, Bhushan P, Sumit P, Piyush P, Aniket K. Clinical outcomes of patients presenting as fever with thrombocytopenia in Marathwada region. Headache. 2016;52:35.

Lohitashwa SB, Gutthi LP, Vegesna S, Pundarikaksha V, Kolla S, Gundapaneni M et al. Clinical and lab profile of fever with thrombocytopenia. Int J Contempt Med Res. 2017;4:1057-61.

Patil P, Solanke P, Harshe G. To study clinical evaluation and outcome of patients with febrile thrombocytopenia. Int J Sci ResPublications 2014;4:1-3.

Nair PS, Jain A, Khanduri U, Kumar V. A study of fever associated with thrombocytopenia. J Assoc Physicians of India. 2003;51:1151-73.

Saini KC, Agrawal RP, Kumar S, Tantia P, Thakkar K, Sharma AK. Clinical and Etiological Profile of Fever with Thrombocytopenia-A Tertiary Care Hospital Based Study. J Assoc Physicians of India. 2018;66:33.