Estimate the incidence and pattern of reactive thrombocytosis among febrile young infants with serious bacterial infection

Rohit Chib; Mohsin Rashid; Surinder Kumar

doi:10.18203/2349-3291.ijcp20161050

Authors

Rohit Chib Department of Pediatrics, Government Medical College Srinagar, Kashmir, India
Mohsin Rashid Department of Pediatrics, Government Medical College Srinagar, Kashmir, India
Surinder Kumar Department of Pediatrics, Government Medical College Srinagar, Kashmir, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20161050

Keywords:

SBI, Platelets, Fever, Infant, Diagnosis

Abstract

Background: Thrombocytosis or elevation in the peripheral blood platelet count to values >400,000/μL is common in infancy and childhood, occurring in 3 to 13% of children. The objective of study was to estimate the incidence and pattern of reactive thrombocytosis among febrile young infants with serious bacterial infections (SBIs).

Methods: The study was conducted in the Postgraduate Department of Pediatrics, G.B. Pant hospital, an associated hospital of Govt. Medical College Srinagar, which is a referral tertiary care hospital for the children of Kashmir valley. The study was a prospective non-randomized study conducted from April 2011 to March 2012. All infants of age 30-89 days admitted in hospital with rectal temperature >38^◦C/100.4^◦F without an apparent focus of infection on history and clinical examination were included in the study.

Results: The incidence of reactive thrombocytosis >4 lakh/mm3 in our study was 33 out of 39 (84.6%) in SBI versus 60 out of 110 (54.5%) in Non-SBI, which was statistically significant in SBI, p value < 0.05. Mean platelet count in urinary tract infections was 5.3 lakh/mm3, bacterial meningitis 5.2 lakh/mm3, occult bacteremia 4.9 lakh/mm3, pneumonia 4.7 lakh/mm3 and 3.9 lakh/mm3 across Non-SBI.

Conclusions: The incidence of reactive thrombocytosis >4 lakh/mm3 in our study was significantly higher in SBI (84.6%) than in Non-SBI (54.5%), p value < 0.05. Mean platelet count was highest in urinary tract infections followed by bacterial meningitis, occult bacteremia and pneumonia. So platelet count >4 lakh/mm3, reactive thrombocytosis, being simple and easy test to perform can be used for early prediction of SBI.

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References

Sutor AH. Thrombocytosis in childhood. Semin Thromb Hemost. 1995;21:330-9.

Kaushansky K. Thrombopoietin: the primary regulator of platelet Production. Blood. 1995;86:419-31.

Papageorgiou T, Theodoridou A, Kourti M, Nikolaidou S, Athanassiadou F, Kaloutsi V. Childhood essential thrombocytosis. Pediatr Blood Cancer. 2006;47:970-1.

Dror Y, Zipursky A, Blanchette VS. Essential thrombocythemia in children. J Pediatr Hematol Oncol. 1999;21:356-63.

Dame C, Sutor AH. Primary and secondary thrombocytosis in Childhood. Br J Haematol. 2005;129:165-77.

Heng JT, Tan AM . Thrombocytosis in childhood. Singapore Med J. 1998;39:485-7.

Vora AJ, Lilleyman JS. Secondary thrombocytosis. Arch Dis Child. 1993;68:88-90.

Sandoval C. Thrombocytosis in children with iron deficiency anemia: series of 42 children. J Pediatr Hematol Oncol. 2002;24:593.

Yohannan MD, Higgy KE, al-Mashhadani SA, Santhosh-Kumar CR. Thrombocytosis Etiologic analysis of 663 patients. Clin Pediatr. 1994;33:340- 3.

Denton A, Davis P. Extreme thrombocytosis in admissions to paediatric intensive care: no requirement for treatment. Arch Dis Child. 2007;92:515-6.

Vlacha V, Feketea G. Thrombocytosis in pediatric patients is associated with severe lower respiratory tract inflammation. Arch Med Res. 2006;37:755-9.

Garoufi A, Voutsioti K, Tsapra H, Karpathios T, Zeis PM. Reactive thrombocytosis in children with upper urinary tract infections. Acta Paediat. 2001;90:448-9.

Robey C, Chmel H. Thrombocytosis associated with acute osteomyelitis. Infection. 1984;12:384-6.

Baraff LJ, Oslund SA, Schriger DL, Stephen ML. Probability of bacterial infections in febrile infants less than three months of age: a metaanalysis. Pediatr Infect Dis J. 1992;11:257-64.

Hsiao AL, Chen L, Baker MD. Incidence and predictors of serious bacterial infection among 57 to180-day-old infants. Pediatrics. 2006;117:1695-701.

Baker MD, Avner JR, Bell LM. Failure of infant observation scales in detecting serious illness infebrile, 4- to 8- week-old infants. Pediatrics. 1990;85:1040-3.

Ishimine P. Fever without source in Children 0 to36 months of age. Pediatr Clin North Am. 2006;53:167-94.

Fouozas S, Mantagou L, Skylogianni E, Varvarigou. Reactive Thrombocytosis in Febrile Young Infants with Serious Bacterial Infection From the Department of Pediatrics, University Hospital of Patras, Patras, Greece.Indian Pediatr. 2010;47:937-43.

Consensus Statement on Management of Urinary Tract Infections. Indain Pediatrics. 2001;38:1106-15.

Nelson Textbook of Pediatrics. 1996;2;603:2936-48.

Craig JC, Williams GJ, Jones M. The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15 781 febrile illnesses BMJ. 2010;340:c1594.

Galetto-Lacour A, Zamora SA, Gervaix A. Bedside procalcitonin and C-reactive protein tests in children with fever without localizing signs of infection seen in a referral center. Pediatrics. 2003;112;1054-60.

Pulliam PN, Attia MW, Cronan KM. C-reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infection. Pediatrics. 2001;108;1275-9.