A STUDY OF PATIENTS OF FEVER WITH THROMBOCYTOPENIA ADMITTED IN GOVT. GENERAL HOSPITAL, KURNOOL.

Dr.Shaik Syfulla Shariff; Dr.K.Narasimhulu

Volume : VIII, Issue : II, February - 2018

A STUDY OF PATIENTS OF FEVER WITH THROMBOCYTOPENIA ADMITTED IN GOVT. GENERAL HOSPITAL, KURNOOL.

Dr. Shaik Syfulla Shariff, Dr. K. Narasimhulu

Abstract :

BACK GROUND:

Fever is a common manifestation of illness that is not surprising to find accurate description of the feile patients in early recorded history. Through thrombocytopenia is encountered in various diseases, it is fortunate that potentially fatal bleeding due to thrombocytopenia is rare. Platelets play a important role in normal haemostatis and also in thrombosis. The common causes of fever with thrombocytopenia are infections like dengue, leptospirosis, malaria, typhoid, military TB, HIV, septicaemia.

Early diagnosis and treatment of the underlying condition and platelet transfusions are required to prevent fatal outcomes. Hence there is a need for the study to know the clinical profile and complications of fever with thrombocytopenia in the local regions. The objective of the study was to evaluate the clinical profile of patients with fever and thrombocytopenia, attending the Govt. General Hospital, Kurnool.

METHODS

100 patients presenting with fever and thrombocytopenia were taken up for study.

INCLUSION CRITERIA: Patients presenting with fever of >38°C and thrombocytopenia that is a platelet count of <1 lakh.

EXCLUSIVE CRITERIA: Patients aged <18 years without fever and thrombocytopenia; Inherited causes for thrombocytopenia; HIV infection; Cirrhosis of liver; Leukemias and myelodysplastic syndromes. The diagnostic work up of patients with fever and thrombocytopenia should include a battery of investigations including biochemical tests; haemograms; peripheral smear etc.

RESULTS

Male to female ratio in the present study was 3:1. The patients age ranged from 18–80 yrs. The maximum occurrence of fever with thrombocytopenia was in the 3^rd decade (32%) followed by 4^th decade (28%) and 5^th 17% respectively in the present study.

Dengue fever was the commonest aetiology (47%), followed by viral fever (29), Malaria (13%), Typhoid (6%), Sepsis (4%), Leptospirosis (1%) in the present study. The duration of fever in 92% of cases was < 10 days in the present study.

Petechiae and conjunctival haemorrhage was found in 20% of patients, 50% had abnormal bilirubin levels, 5.88% had abnormal SGOT and 6.25% had abnormal SGPT in patients with dengue fever in present study.

In patients with viral fever 61.54% had abnormal bilirubin levels, 15.38% had abnormal SGOT leve3ls and 40% had abnormal SGPT levels. In patients with malaria 75% had abnormal bilirubin levels, 66.67% had abnormal SGOT and SGPT levels, In patient with typhoid 50% had abnormal bilirubin levels, 66.67% had elevation of both SGOT and SGPT levels.

CONCLUSION

All feile illness patients should be investigated for platelet count irrespective of bleeding manifestation or not. Strong probability of dengue fever or other common causes like viral fever, malaria and leptospirosis should be kept in mind in any case of fever and manifestation and could be of bad prognosis if not treated with platelet transfusion early.