Manoj, M (2014) Clinical study of Fever with Thrombocytopenia with special reference to Infective Etiology and complications admitted to Government Royapettah Hospital, Chennai. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
BACKGROUND : Fever with thrombocytopenia is a common condition that is associated with an increased risk of morbidity and mortality. Infections like Malaria, Dengue, Leptospirosis, Typhoid, HIV & septicemia are some of the common causes of fever with thrombocytopenia. Therefore a well organized systemic approach that is carried out with an awareness of causes of fever with thrombocytopenia can shorten the duration of investigations and bring out diagnosis. Hence, a need for study to know the causes and complications of fever with thrombocytopenia. AIMS AND OBJECTIVES : 1. To study the etiology of short duration fever with thrombocytopenia. 2. To study the clinical presentation and the laboratory profile of patients presenting with fever and thrombocytopenia. 3. To assess the correlation of severity of thrombocytopenia with the bleeding manifestation. MATERIALS AND METHODS : This was a cross sectional study which included all new patients above 18 years with fever (temperature > 99.9 F) and thrombocytopenia (platelet count less than 1,50,000 cells/ cu.mm) admitted to Government Royapettah hospital. The data of each patient was collected on a proforma specially designed for this study which includes demographic details, clinical features, past medical history, clinical and Lab values which will be analysed for statistical significance and correlation. RESULTS : In our study the leading cause of febrile thrombocytopenia was malaria. The 2nd leading cause of febrile thrombocytopenia was dengue fever. Typhoid fever accounted for 6% of cases. Patients in whom diagnosis could not be made was 16%. Among the 100 patients in the study group, the maximum number of patients (54%) had a platelet count between 50,000 to 100000. Platelet count less than 20000 were found in only three patients. Only 11% of patients had bleeding manifestations. A total of 9 patients had received transfusion of blood products.7 patients had received fresh whole blood alone and 2 of them had been transfused both fresh whole blood and platelets. The two patients who had received platelet transfusion were having sepsis and malaria. CONCLUSION AND INTERPRETATION : 1) Infections are one of the most common causes of thrombocytopenia. The leading cause of fever with thrombocytopenia in our study was Malaria. 2) In malarial infection, the most common species was Plasmodium vivax followed by Plasmodium falciparum. 3) Dengue fever was the second commonest cause of febrile thrombocytopenia. 4) There is no direct correlation between the severity of thrombocytopenia and the bleeding manifestation. 5) Bleeding manifestation was present only in 11% of patients in the study. So in majority of patients, the thrombocytopenia was transient and asymptomatic. 6) Prophylactic platelet transfusion may not be required in all cases of severe thrombocytopenia. It may be restricted to selected patients with bleeding manifestation or platelets <10,000/cumm which may indicate bone marrow compromise. 7) Most of the patients in our study did not require platelet or blood transfusion and the platelet count significantly increased after the treatment of the underlying infection.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Fever, thrombocytopenia, malaria, dengue, bleeding, platelet count, platelet transfusion. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Pushparaj A |
| Date Deposited: | 28 Jul 2017 12:00 |
| Last Modified: | 03 Feb 2018 16:36 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2354 |
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