ABSTRACT
In the recent period there is an upsurge in the incidence of fever with thrombocytopenia in the Mid Karnataka. This may be due to the several emerging and re-emerging infections which cause frequent epidemics in the region. Early diagnosis and meticulous management will prevent fatal outcome. Studies on fever with thrombocytopenia are very few in Karnataka.METHODSThis was a descriptive study conducted at J.J.M. Medical College, Davangere, over a period of one year from December 2017 to November 2018. The study includes 251 cases attending outpatient- and inpatient-departments in the Department of Medicine. All patients with a platelet count of less than 150000 was included in this study and detailed clinical and laboratory evaluation was done and assessed for the aetiology and outcome.RESULTSAmong the 251 cases, dengue fever accounted for 54.5% of cases and 26.2% were other viral fever cases where the exact causative organism was not identified. Leptospirosis, malaria were also important causes of fever with thrombocytopenia. Major incidence of haemorrhagic manifestation occurred in the age group of 20 to 30 years whose platelet count was in the range of 10000 to 40000/mm3.CONCLUSIONSIn this study, more than 50% had dengue fever and in 26.2% cases the exact aetiology could not be determined. This finding highlights the fact that there may be many unidentified infections which cause fulminant thrombocytopenia and there is a need for wider screening of infection.
ABSTRACT
Background: Dengue, the most common arboviral disease worldwide is usually endemic but several epidemics have been recorded. Global incidence of dengue has grown dramatically in recent decades; about half of the world's population is now at risk. The situation in India is reflected by occurrence of major disease outbreaks from time to time over the last few decades. Objectives: The objective of the present study was to observe the various clinical manifestations and complications of dengue fever. Materials and Methods: Study included 100 patients admitted to medicine ward in medical college hospital for a period of 6 months with symptoms and signs suggestive of dengue fever and those positive for NS1Ag, IgM and IgG dengue antibodies using Rapid strip test. Results: Among 100 patients observed, majority cases were dengue fever (92%) with no mortality, 5% were dengue hemorrhagic fever (DHF) with mortality 20% and 3% were dengue shock syndrome (DSS) with mortality 67%. 71 were males and 29 were females with sex ratio 2.5:1. Maximum patients were in the age group of 18-30years. Most common clinical manifestations were fever (100%), headache (90%), abdominal pain (72%), arthralgia (65%), myalgia (64%), hepatomegaly (52%) and splenomegaly (41%). Thrombocytopenia (84%) is the most common hematological abnormality observed. Among serology positivity, majority were positive for NS1 antigen (81%), followed by IgM antibodies (7%) and mixed positivity (12%). Most common complication observed was hepatic dysfunction (33%). Conclusion: Dengue infection is common viral infection with varying clinical manifestations from region to region and epidemic to epidemic. Even though no specific treatment available for dengue fever but early diagnosis and timely intervention will prevent complications and mortality from dengue hemorrhagic fever and dengue shock syndrome.