SPECTRUM OF FEBRILE THROMBOCYTOPENIA AMONG CHILDREN IN A TROPICAL COUNTRY: A HOSPITAL BASED OBSERVATIONAL STUDY IN DHAULADHAR REGION

Abstract

Background: Pediatric admissions often involve febrile thrombocytopenia. Infections are the main cause however noninfectious reasons occur. This study estimated the prevalence of thrombocytopenia in pediatric fever patients, its etiologies, presentations, and the association between platelet count and disease severity and prognosis. Methods: Retrospective observational study done by collecting data fromhospital records of children admitted inRPGMC Tanda from January 2021 to December 2022. Children in the age group of 6 months to15 years with fever and thrombocytopenia at admission were included in the study. Children on treatment with antiplatelet drugs, other chronic diseases and infants less than 6 months were excluded. Results: 48% had high-grade fever at presentation. Fever averaged 4–6 days and peaked at 14 days. Constitutional symptoms (vomiting, abdominal pain) followed. Respiratory and diarrheal manifestations were rare. Seizures and altered sensorium were present in 4%. The next most common clinical finding was hepatomegaly with right hypochondrial tenderness (44%), followed by fluid leak (ascites, pleural effusion) (40%), periorbital puffiness (30%), subcutaneous bleeds (20%), conjunctival congestion (14%) and splenomegaly (14%). Conclusions: Dengue-endemic children have febrile thrombocytopenia. Thrombocytopenia with abdominal pain, vomiting, or oliguria suggests dengue. Enteric fever, scrub typhus, and chikungunya induce similar symptoms. Leukemia, idiopathic thrombocytopenic purpura, hemolytic uremic syndrome, and sepsis can induce febrile thrombocytopenia. Blood and antibiotics are unusual.