Hematological parameters in fever evaluation - A prospective study

Abstract

Introduction: The common causes of acute febrile illnesses (AFI) are malaria, dengue, typhoid, Chikungunya fever, meningitis, Urinary Tract Infection (UTI) and other miscellaneous diseases. Aim: To detect if certain hematological parameters would increase the probability to reach a provisional diagnosis of various acute febrile illnesses and prompt institution of specific therapy. Materials and Methods: This prospective study was conducted in Department of Pathology, for 2years in Sri Siddhartha Medical College, TUMKUR, from June 2016 to May 2018 and included total 100 cases of acute febrile illnesses in age group 21 to 60 years. Complete blood count and malarial parasite microscopy were performed for each patient. Other relevant tests wherever required, were done for confirmation of diagnosis. Results: Among 100 cases of AFI, malaria was detected in 17%, dengue in 26%, typhoid in 16.%, UTI in 17%, meningitis in 6% and non-specific fever in 18%. There were 55/100 males and 45//100 females. Maximum number of cases (44%) were seen in age group 21 to 30 years. Thrombocytopenia, anemia, increased Red Cell Distribution Width (RDW) and Platelet Distribution Width (PDW) while reduced Packed cell volume (PCV) showed a statistically significant correlation in malaria. A relatively more thrombocytopenia, anemia and reduced RBC and PCV were noted in P. falciparum in comparison to P.vivax. In dengue, a more reduction in platelet count, leucopenia with lymphocytosis and 56% cases with reduced PCV were noted. Increase in TLC and neutrophil count was consistent features seen in UTI and meningitis. In typhoid patients normal platelet count, mild anemia and mildly reduced PCV was observed while comparing with malaria. Conclusion: We conclude that routinely used laboratory tests such as hemoglobin, PCV, leukocyte count, platelet count and even red cell indices can act as diagnostic indicators in patients with acute febrile illness.