A Clinical Study of the Association of Thrombocytopenia with Acute Febrile Illness

Gangum Venkatreddy, Shireesha Gugloth
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Abstract

Abstract Background: Thrombocytopenia accompanying acute febrile illnesses is a matter of concern because lack of prompt treatment could result in significant mortality. We in this study tried to evaluate the clinical profile of cases with acute fever and thrombocytopenia and determine the cause of fever with thrombocytopenia and the outcome of treatment of such patients in our hospital. Methods: A total of n=50 successive cases of acute febrile illness with thrombocytopenia following inclusion and exclusion criteria were included in this study. Clinical signs such as rashes, signs of dehydration, petechiae, jaundice, lymphadenopathy, hepatomegaly, splenomegaly, anemia, abdominal tenderness, altered sensorium, were noted. Investigations included CBP, ESR, LFT, RFT, serum electrolytes, Chest X-ray, USG abdomen were done. Other investigations included Dengue serology, Malaria, Widal, IgM for leptospirosis, sputum for AFB. Results: Out of n=50 patients with acute fever with thrombocytopenia, all of them had a definitive diagnosis with malaria (40%) as the commonest cause, followed by enteric fever (24%), viral fever (14%), septicemia (6%), dengue (14%), and leptospirosis (2%). 50% of the patients had platelet count in the range of 50, 000 – 1,00, 000 and 30% had platelet counts above 100000-150000. 8% of cases had platelet counts below 25000 and 12% had platelet counts between 25000-50000 at the time of admission. 10% mortality was observed. Conclusion: infections as the commonest cause of thrombocytopenia. Malaria, dengue enteric fever, leptospirosis, and other viral infections formed the major diseases in this group of population. The diagnosis of malaria was the common cause because of seasonal and regional variations. A definitive increase in platelet count was noted after the underlying cause was treated. Severe cases of septicemia with associated co-morbidities resulted in mortality.
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血小板减少症与急性发热性疾病相关性的临床研究
摘要背景:伴随急性发热性疾病的血小板减少是一个令人担忧的问题,因为缺乏及时的治疗可能导致显著的死亡率。在这项研究中,我们试图评估急性发热和血小板减少症病例的临床特征,并确定发热伴血小板减少症的原因以及在我们医院对这些患者的治疗结果。方法:本研究纳入了符合纳入和排除标准的连续50例急性发热性疾病伴血小板减少症。临床症状如皮疹、脱水症状、瘀点、黄疸、淋巴结病、肝肿大、脾肿大、贫血、腹部压痛、感觉功能改变。调查包括CBP、ESR、LFT、RFT、血清电解质、胸部X光片、USG腹部。其他调查包括登革热血清学、疟疾、Widal、钩端螺旋体病IgM、AFB痰。结果:在50例急性发热伴血小板减少症患者中,所有患者都得到了明确诊断,疟疾(40%)是最常见的病因,其次是肠热(24%)、病毒热(14%)、败血症(6%)、登革热(14%)和钩端螺旋体病(2%)。50%的患者血小板计数在50000–10000之间,30%的患者血小板数在100000-150000之间。8%的病例在入院时血小板计数低于25000,12%的病例在25000-50000之间。观察到10%的死亡率。结论:感染是血小板减少症最常见的病因。疟疾、登革热、钩端螺旋体病和其他病毒感染是这一人群的主要疾病。由于季节和地区差异,疟疾的诊断是常见的原因。治疗潜在病因后,血小板计数明显增加。严重的败血症合并并发症导致死亡。
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