Clinicoetiological profile and outcome of acute febrile illness with thrombocytopenia in children: a hospital based prospective study

'Background: Thrombocytopenia is often the most commonly encountered clinical condition in this routine practice. Etiological causes being numerous, often pose a challenge in evaluating and treating the patients. The objective of this study was to find out the different causes and clinical profile of fever with thrombocytopenia in children aged 1month to 14 year who were admitted in this set up.Methods: This was a prospective study done on 200 patients with thrombocytopenia admitted IMS AND SUM Hospital, BBSR with various complaints, during the period of 01 August 2017 to 01 August 2019. This study includes age group 1months to 14 years.Results: The highest incidence of thrombocytopenia belonged to the age group 11-14 years (22.5%) followed by 6-9 years (19.5%) and 3-6 years (18%). Incidence of thrombocytopenia was more in male child (58.5%) as compared to female child (41.5%). the most common cause of thrombocytopenia was dengue (50%), Scrub typhus (34%) septicaemia (17.5%) followed by malaria (10.5%). Among the infectious aetiology severe thrombocytopenia was seen more in dengue (25%) and scrub typhus (34.5%) but evidence of bleeding was seen more in sepsis (34.2%) even with higher platelet count which may be explained by associated multi organ failure.Conclusions: Infections like malaria, dengue, leptospirosis and septicaemia were the common causes of thrombocytopenia along with scrub typhus. Whenever thrombocytopenia is detected further investigations can help us in reaching a correct diagnosis in the majority of the cases so that appropriate treatment can be given and also to avoid unnecessary platelet transfusion to prevent transfusion related complications.

Primary malignant fibrous histiocytoma involving the left pulmonary vein presenting as a left atrial tumor.

A 35‑year-old woman presented with 4 months history of progressively increasing intermittent dyspnea and hemoptysis. Transthoracic echocardiography revealed a loculated mass in the left atrium (LA). A provisional diagnosis of LA myxoma was made. Intraoperatively the tumor was found extending into and closely adherent to the left pulmonary vein and could not be completely cleared off from the pulmonary venous wall. The histopathological examination of the tumor revealed it to be a myxoid malignant fibrous histiocytoma.

A rare case of a left atrial hemangioma mimicking a myxoma.

A 68-year-old gentleman presented with a recent history of exertional dyspnea associated with anginal chest pain. Transthoracic echocardiography revealed a well-circumscribed mass in the left atrium attached to the inter-atrial septum. A provisional diagnosis of left atrial (LA) myxoma was made. Coronary angiography revealed significant single-vessel disease. The patient underwent coronary artery bypass grafting and resection of the LA tumor. The histopathological diagnosis of the tumor came out to be a cardiac hemangioma.