Evaluation of Febrile Thrombocytopenia Cases in a South Indian Tertiary Care Hospital.

Objective: This study is aimed at analyzing the clinical symptomatology and hematological evaluation with an emphasis on platelet indices in relation to predicting the outcome of the febrile thrombocytopenic patients admitted in Coimbatore medical college hospital..

Methods: This is a prospective study involving 100 adult patients who presented to our hospital with fever and thrombocytopenia (platelet <1,50,000). This study excluded patients with known causes of thrombocytopenia like ITP and patients on chemotherapy etc.

Results: Out of 100 patients 34 were dengue positive, 66 were dengue negative. Dengue specific symptoms like myalgia and retro-orbital pain were present in 58.88% of dengue positive and 10.60% of dengue negative patients. Laboratory evaluation revealed sharp rise in hematocrit with fall in platelet count in both the groups more significant in dengue positive group. Bleeding manifestation and rashes were 29.4% and 26.4% in dengue positive, 12.12% and 7.57% in dengue negative group respectively. MPV was significantly lower in patients with bleeding manifestations irrespective of platelet count in both the groups. Mortality in our study was 2%.

Conclusion: : MPV is an independent predictor of bleeding manifestation and poor outcome. Dengue virus may suppress the bone marrow as evidenced by alteration in MPV in addition to other mechanisms of thrombocytopenia.