Study of febrile thrombocytopenia in Malwa region of India

Abstract

Background: Febrile thrombocytopenia is the thrombocytopenia associated with fever. Diseases which commonly present with fever and thrombocytopenia are malaria, leptospirosis, septicemia, typhoid, arbovirus diseases such as dengue.Aims and Objectives: The study was intended to know the underlying etiology of febrile thrombocytopenia in Malwa region and its various presentations.Materials and Methods: This study was conducted at Department of General Medicine of a tertiary care centre for two years. Five-hundred adult patients (age >18 years) of febrile thrombocytopenia were evaluated for possible inclusion in this study. Routine investigations including complete blood counts, peripheral smear examination, kidney function tests, liver function tests, ultrasound of abdomen were done in all subjects. The specific investigations were done as and when indicated.Results: Out of 500 patients of febrile thrombocytopenia, 298 were male, while 202 were female. Commonest symptom after fever was malaise (83%) followed by nausea-vomiting (76%), headache (63.4%), jaundice (26.8%), easy fatigability (22.4%), bleeding manifestations (7.8%), cough (6.8%), dyspnea (5.8%), rash (2.4%) and delirium (1.4%). Dengue was found in 178 patients. Malaria was found in 122 patients. Other causes of febrile thrombocytopenia were septicemia (22 cases), leptospirosis (12 cases), chikungunya fever (10 cases), viral hepatitis (9 cases), enteric fever (9 cases), acute lymphoblastic leukemia (2 cases), non-hodgkin lymphoma (one case), disseminated tuberculosis (one case).Conclusion: Febrile thrombocytopenia is an important clinical condition commonly caused by infections, particularly viruses and malaria. Such studies will help in finding changing trends of locally prevalent infectious diseases and finding some new emerging diseases not prevalent in the particular region.Asian Journal of Medical Sciences Vol.8(5) 2017 83-86

A Study of Febrile Thrombocytopenia

“…HIV was reported as viral fever in the study by Modi T et al 6 , 5% patients of study by Gondhali MP et al 12 and which was reported as 1(0.11%) patient in our study. In our study 59.53% patients had platelet count within 50000-100000/ mm 3 range compared to 57.14% in study by Gandhi A A et al 5 , 53% in Fawas M N et al 7 , 53.8% in Yadav and Singhai et al 11 In our study 4% of patients had platelet count less than 20000, compared to study by Gandhi A A et al 5 which is 13.39%, in Fawas M N et al 7 5% and in Yadav and Singhai et al 11 11.8%. Bleeding manifestations were seen in 24.3% patients in our study as compared to study by Yadav and Singhai et al 11 which is 7.8%, in Fawas M N et al 7 17%, in Gondhali MP et al 12 24%.Petechiae was the commonest bleeding manifestation of 14% in our study followed by mucosal bleeding in 10.3%patients which is similar to study by Gondhali MP et al 12 In our study when the platelet count was between 20000-50000 / mm 3 .…”

“…7 Rickettsial fever was the second common cause of febrile thrombocytopenia with increasing trend from 21.9% in 2016 to 26% in 2017 and 33.4% in 2018.Rickettsial fever was suspected in 6.6% patients of study by Suneetha et al 8 conducted in Mysuru, and also reported in 2.5% patients in study by Hariprasad S et al 9 conducted in raichur, Karnataka. Undifferentiated fever was the third common cause of febrile thrombocytopenia and was 29.3% in 2016, 9% in 2017 and 12.2% in 2018.Undifferentiated fever was reported as most commonest cause in studies by Suneetha et al (61.4%) 8 , Naveen Kulkarni et al(62.5%) 10 , Yadav and Singhai et al(35.6%) 11 , The other causes of febrile thrombocytopenia in our study was septicemia in 1.9%, enteric fever in 1.6%, malaria in 0.9%, malignancy in 0.23% with 2 cases of acute leukemia, HIV in 0.11%. The incidence of septicemia was 0.8% in the study by Fawas M N et al 7 , 8% each in the studies by suneetha et al 8 , Naveen Kulkarni et al 10 , 12.5% in the study by Hariprasad S et al 9 The incidence of enteric fever was 6.5% in the study by Naveen Kulkarni et al 10 , 2% in the study by suneetha et al 8 , 1.8% in the study by Yadav and Singhai et al 11 , 0% in the studies by Fawas M N et al 7 and Hariprasad S et al 9 The incidence of malaria is 28.5% in the study by Hariprasad S et al 9 , 24.4% in the study by Yadav and Singhai et al 11 , 13% in the study by Naveen Kulkarni et al 10 and lower incidence of 2% in the study by Suneetha et al 8 The incidence of hematological malignancy was reported of 0.6% in the study by Yadav and Singhai et al 11 , 1.79% in the study by Gandhi A A et al 5 which was 0.23% in our study.…”

Fever with Thrombocytopenia in the Pediatric Age Group

“…Yadav V et al's study [24] on a sample of 500 cases included 298 males and 202 females. Viral fever was the most frequent cause of febrile thrombocytopenia in our study (35.6%).…”