DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20211669

Study on reactive thrombocytosis in febrile young infants with serious bacterial infection in a tertiary care hospital

Nasreen Chidhara

Abstract


Background: Thrombocytosis associated with multiple, simultaneous causative factors was also reported in many children. Among all patients with infections, osteomyelitis and septic arthritis were associated with higher platelet counts than other infections. This study was done to estimate the prevalence of reactive thrombocytosis among febrile young infants and to assess the utility of platelet count as a potential predictor of serious bacterial infection.

Methods: The study was a cross-sectional study conducted in the department of paediatrics, Kanchi Kamakoti child's trust hospital, Nungambakkam, Chennai. 140 children were included in the study. Venepuncture was done in all these children. Blood sample of 3 ml was collected in an EDTA tube for complete blood count and in another tube 2 ml of blood was collected for CRP.

Results: The prevalence of reactive thrombocytosis was 65.8% in the population with serious bacterial infection (SBI). The proportion of children having respiratory symptoms in the study population was 70%, which was the most common system affected. Gastrointestinal, CNS and genito-urinary symptoms were seen in 29.29%, 11.43% and 10.00% of subjects respectively. Other miscellaneous symptoms were reported in 4.29% of the patients.

Conclusions: The prevalence of SBI was highest (30.2%) in the 4 to 6 months age group. The prevalence of SBI in 1 to 3 months, 7 months and above age groups was 28.6% and 29% respectively.


Keywords


SBI, Platelets, Fever, Infant, Diagnosis

Full Text:

PDF

References


Shin SH, Choi CW, Lee J, Kim E, Choi EH, Kim H, et al. Risk factors for serious bacterial infection in febrile young infants in a community referral hospital. J Korean Med Sci. 2009;24(5):844-8.

Bachur RG, Harper MB. A predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics. 2001;108(2):311-6.

Bleeker SE, Derksen-Lubsen G, Grobbee DE, Donders ART, Moons KGM, Moll HA. Validating and updating a prediction rule for serious bacterial infection in patients with fever without source. Acta Paediatr. 2007;96(1):100-4.

Cincinnati V, Brescia L, Esposito S. Thrombocytosis and infections in childhood. Pediat Infect Dis J. 2012;31(1):80-1.

Chen CJ, Lo YF, Huang MC, Chung RL, Tang RB, Wu KG. A model for predicting the risk of serious bacterial infection in febrile infants younger than 3 months of age. J Chin Med Assoc. 2009;72(10):521-6.

Carcillo JA. Reducing the global burden of sepsis in infants and children: a clinical practice research agenda. Pediatr Crit Care Med. 2005;6:157-64.

Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999;534(9194):1955-61.

Hsiao AL, Baker MD. Fever in the millennium: a review of recent studies of markers of serious bacterial infection in febrile children. Curr Opin Pediatr. 2005;17(1):56-61.

Sur DK, Bukont EL. Evaluating fever of unidentifiable a source in young children. Am Fam Physician. 2007;75(12):1805-11.

Vlach V, Fekete G. Thrombocytosis in pediatric patients is associated with severe lower respiratory tract inflammation. Arch Med Res. 2006;37(6):755-9.

Wang JL, Huang LT, Wu KH, Lin HW, Ho MY, Liu HE. Associations of reactive thrombocytosis with clinical characteristics in pediatric diseases. Pediatr Neonatol. 2011;52(5):261-6.

Wiedmeier SE, Henry E, Burnett J, Anderson T, Christensen RD. Thrombocytosis in neonates and young infants: a report of 25 patients with platelet counts of > or = 1000000 micro (-1). J Perinatol. 2010;30(3):222-6.

Yohannan MD, Higgy KE, al-Mashhadani SA, Santhosh-Kumar CR. Thrombocytosis. Etiologic analysis of 663 patients. Clinic Pediat. 1994;33(6):340-3.

Mantadakis E, Tsalkidis A, Chatzimichael A. Thrombocytosis in childhood. Indian pediatrics. 2008;45(8):669-77.

Sutor AH. Thrombocytosis in childhood. Semin Thromb Hemost. 1995;21(3):330-9.

Focus S, Mantagou L, Skylogianni E, Varvarigou A. Reactive thrombocytosis in febrile young infants with a serious bacterial infection. Indian Pediatr. 2010;47(11):937-43.

Brown LST, Wittlake WA. Does leucocytosis identify bacterial infections in febrile neonates presenting to the emergency department? Emerg Med J. 2005;22(4):256-9.

Olaciregui I, Hernández U, Muñoz JA, Emparanza JI, Landa JJ. Markers that predict serious bacterial infection in infants under 3 months of age presenting with fever of unknown origin. . Arch Dis Chi. 2009;94(7):501-5.

Bressan S, Andreola B, Cattelan F, Zangardi T, Perilongo G, Dalt LD. Predicting severe bacterial infections in well-appearing febrile neonates: laboratory markers accuracy and duration of fever. Pediatr Infect Dis J. 2010;29(3):227-32.

Blavatsky E, Yarden-Bilavsky H, Ashkenazi S, Amir J. C-reactive protein as a marker of serious bacterial infections in hospitalized febrile infants. Acta Paediatrica. 2009;98(11):1776-80.