Spectrum of Febrile Thrombocytopenia in the Pediatric Population (1-18 Years) Admitted in a Tertiary Care Center

Abstract

Aim Thrombocytopenia is a common manifestation of various infections. Thrombocytopenia associated with fever helps to narrow down the differential diagnosis and management of fever. It also helps to know the various complications of thrombocytopenia, its management, and the outcome of the patient. This study aimed to evaluate the clinical profile and determine etiology and complications in patients with fever and thrombocytopenia in pediatric populations. Methods One hundred and fifteen patients of both sexes aged 1-18 years with fever and found to have thrombocytopenia (platelet count < 1.5 lakhs) between June 1, 2018 and March 31, 2019 were included in this study. Results Infection was the common cause of febrile thrombocytopenia and dengue fever was the most common infection. Bleeding manifestations were seen in 9.6 % of patients. Petechiae/purpura was the commonest bleeding manifestation followed by gum and nose bleeding. Common bleeding manifestations were seen in patients with a platelet count below 50,000 and the majority of them did not require platelet transfusion. Good recovery was noted in 96.5% of patients while 2.6% had mortality. Conclusions An infection, particularly dengue, was the common most cause of fever with thrombocytopenia. In the majority of patients, thrombocytopenia was transient and asymptomatic. Bleeding was present in the majority of patients with platelets less than 10,000 and 20,000 to 50,000. The most common bleeding manifestation was petechial rashes over the skin. Platelet transfusion was not required in most of the cases. On treating the specific cause, a drastic improvement in the platelet count was noted during discharge and further follow-up. Immunization is highly recommended for vaccine-preventable diseases.