Assessment of Clinical Profile and Management of Viral Fever with Thrombocytopenia in Paediatric Patients

INTRODUCTION: Viral fevers with thrombocytopenia is common especially during monsoon season. Viral fevers can cause thrombocytopenia. It is a major challenge to public health especially in South East Asia. We have done an observational study of viral fevers with thrombocytopenia in which we have studied the clinical profile and management pattern of viral fevers with thrombocytopenia. AIMS AND OBJECTIVES: A observational study was carried out in pediatric patients. Data was collected by intensive care record review. Patients of age group 1-14years of both gender diagnosed of viral fever with thrombocytopenia were included. Clinical parameters and prescribing pattern in children presenting at various stages of viral fever with thrombocytopenia was analyzed. RESULTS: A total of 130 patients diagnosed with viral fever with thrombocytopenia with one or more warning signs were admitted during the study period. Most of the cases admitted are between 7-12 years (42%). Most admitted Gender is male 75(58%). Most common sign and symptom is fever 130(100%). Most of the cases have platelet count less than 1lakh cu.mm (65%). PCV increased in 64 cases (49%). 20% cases had hepatomegaly. In management IV fluids given was DNS 110(85%), followed by ringer lactate and other. Most common Antibiotics prescribed was Ceftriaxone+sulbactam 65(50%), followed by Piperacillin+Tazobactam 45(34%), and other symptomatic treatment was given consist of Paracetamol 130(100%), H2 Blocker(ranitidine) 130(100%), corticosteroids 130(100%), and Anti-emetics(Ondansetron) 61 (47%). Platelet transfusion done to 11 (8.5%). CONCLUSION: Viral fevers like Dengue are the commonest cause for thrombocytopenia. Antibiotics though not a part of standard World Health Organization was seen to be an important part of management. Supportive care with judicious fluid management during the critical and recovery period with continuous monitoring is required for all patients. Dandiala Sireesha*, Maneesha Doule, Sai Laxmi M, Gajula Kiranmai, Pravallika Pasupuleti Kakatiya University, Warangal, Telangana, India. Submission: 24 July 2020 Accepted: 30 July 2020 Published: 30 August 2020 www.ijppr. humanjournals.com Citation: Dandiala Sireesha et al. Ijppr.Human, 2020; Vol. 19 (1): 658-686. 659 INTRODUCTION Viral fever like dengue that causes thrombocytopenia is a self-limiting acute mosquito borne disease characterized by fever, headache, muscle and joint pains, rash, nausea and vomiting. It is caused by an arbovirus and spread by Aedes mosquitoes. Some infections result in hemorrhagic manifestations and in its severe form is known as dengue shock or severe dengue, which can threaten the patient’s life primarily through increased vascular permeability and hypertensive shock. Time and again dengue has given rise to pandemics all over the world. Dengue has a wide spectrum of clinical presentations, often with unpredictable clinical evolution and outcome. A small proportion progress to severe disease characterized by plasma leakage with or without hemorrhage. World Health Organization (WHO) has conferred it as a notifiable disease and since 2005 dengue is considered as a public health emergency of international concern. [1] WHO statistics have also shown that dengue burden from children in South East Asian Region (SEAR) countries is increasing. The first evidence of occurrence of dengue fever in India was reported during 1956. Every year during the period of July to November there is an upsurge in the cases of dengue /DHF. [2] Children are at higher risk of acquiring severe dengue. Epidemiological studies conducted in India during 2001 dengue epidemic have shown that DHF has been predominantly restricted to children. [3-5] Reports from other studies have shown that deaths due to dengue are potentially avoidable, and morbidity can be reduced to a great extent with appropriate measures. A broad-angled evaluation with integration of clinical and laboratory parameters would direct the disease process as well as the on-going treatment and outcome of the disease.