Study of clinical and laboratory profiles of children presented with fever with thrombocytopenia at a tertiary care hospital, Srikakulam

ABSTRACT Background: Acute febrile thrombocytopenia is a common clinical problem that we come across in our medical wards. Common causes include dengue, leptospirosis, chikungunya, malaria, enteric fever, rickettsial fever, scrub typhus, ITP, ALL, and hematological malignancy. Of these, infections are the most common cause. It is characterized by bleeding most often from small vessels. It can manifest as petechiae/purpura over the skin and hemorrhages from the mucosa in the form of melena, hematemesis, and hematuria. Intracranial hemorrhage is a life-threatening consequence in thrombocytopenic patients. The present study aims to evaluate the clinical, etiological, and laboratory profiles of febrile thrombocytopenia. Therefore, a well-organized approach which is carried out with an awareness of the causes of febrile thrombocytopenia narrows down the differential diagnosis and helps to bring out a specific diagnosis. Study Design: A hospital-based observational study was conducted on patients with age 1 month to 12 years of either sex, having fever with thrombocytopenia admitted to the pediatric ward, Government General Hospital, Srikakulam. Results: Infections were the most common causes of febrile thrombocytopenia, and dengue was seen in 30% (n = 40) of the study group. 34 (25%) children who had bleeding manifestations. 85% of children had petechiae/purpura, followed by GI bleeds like hematemesis and melena in 52%. 94% of children recovered, and 6% mortality was seen. Septicemia alone caused one-third of mortality. Conclusion: Infections, particularly dengue, are one of the common causes of fever with thrombocytopenia. In many children, thrombocytopenia was not associated with any type of bleed and it was transient at most times, but there were bleeding manifestations in some children. Spontaneous bleeding was noted in patients who had a platelet count of <10,000/μL, and petechiae/purpura were commonly seen bleeds. On treating the primary cause, there was an improvement in the platelet count, which was noted during discharge.