Analysis of predictors in outcome of fever with thrombocytopenia of pediatric age upto 12 years
Keywords:Bleeding manifestations, Hepatomegaly, Platelet count, Thrombocytopenia, Widal test
Background: It is well recognized that many fetomaternal and neonatal conditions are associated with thrombocytopenia. Study aimed to establish the possible etiology of children presenting with thrombocytopenia.
Methods: The study was carried out in 100 children 1 month-12 years, admitted at department of paediatrics, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India with fever and thrombocytopenia. A thorough history was obtained and a general and systemic examination done. Routine investigations were done in all cases and specific investigations as and when required.
Results: Total 100 cases were studied. Among them, 65% developed only fever, 10% developed fever with bleeding and 25% developed fever with shock. In total admissions 55% of children admitted with warning symptoms including abdominal pain, vomiting, reduced urine output and black colored stools. There is a significant influence of warning symptoms in predicting the outcome of fever with thrombocytopenia. 30% of children admitted with respiratory distress. 30% of children admitted with abdominal distension. 60% children admitted with hepatomegaly. In these children, 20% of them developed fever with shock and 13% of them developed fever with bleeding, 52% children admitted with platelet count less than 1 lakh. In these patients, 19% of them developed fever with shock and 9% of them developed fever with bleeding. 60% had dengue serology positive, 12% had positive Widal test, 8% children had positive urine culture and sensitivity. There was a significant influence of etiology in predicting the morbidity as 15% of children having positive serology for dengue developed fever with shock. 10% of children having positive serology for dengue developed fever with bleeding. Bleeding manifestations were seen most commonly in children with a platelet count less than 50000/μl.
Conclusions: The commonest cause of febrile thrombocytopenia in this study was dengue fever in Children. Platelet count was the predictive of bleeding manifestations.
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