Study of Clinical and Laboratory Profile of Fever with Thrombocytopenia in Tertiary Hospital

Introduction: Fever is the most challenging problem in thefield of medicine, consists of occult manifestation of commondiseases rather than the actual diseases. An A.M temperatureof >37.2°C (98.9°F) or a P.M temperature of > 37.7°C (99.9°F)will be considered as fever. Thrombocytopenia is defined asplatelet count <150,000/µl. This is due to decreased productionof platelets, increased destruction and increased sequestrationin the spleen. Study aimed to evaluate clinical and laboratoryprofile in patients having fever with thrombocytopenia.Material and methods: A series of 100 patients admittedin SMBT Medical College and Hospital with fever andthrombocytopenia were evaluated. During the hospital stay,all the patients were subjected repeat CBC once in 2 days.Follow up of all patients regarding treatment and outcomeswere done during the hospital stay.Results: Out of 100 cases of fever with thrombocytopenia,62 were males and 38 were females. The most common causewas malaria in 38% of cases followed by dengue in 30% ofcases and septicemia in 17% of cases. Based on severity mild,moderate and severe thrombocytopenia observed in 47%, 35%and 18% respectively. Bleeding manifestations were seen in36 patients. 94 patients recovered and 6 expired.Conclusion: Fever with thrombocytopenia is one of thechallenging problems in the field of medicine. Bleedingmanifestations associated with thrombocytopenia were seenamong dengue cases. Platelet transfusions should be carriedout as per WHO guidelines. Thus a well organized systemicapproach needs to be carried out with an awareness ofdifferent causes of fever with thrombocytopenia which canhelp to diagnose and manage the case early

Etiology of Pancytopenia and its Bone Marrow Picture

Introduction: Pancytopenia is an important clinicalhematological entity encountered in our day-to-day clinicalpractice. Pancytopenia may be a presentation of a widevariety of disorders, which primarily or secondarily affect thebone marrow. Study aimed to identify the etiology and bonemarrow morphology of pancytopenia patients.Material and methods: Total 30 non-malignant patientswho had pancytopenia were included in the study. Based onclinical findings bone marrow aspiration and trephine biopsywere carried out. All the bone marrow aspirate smears werestained with May-Grunwald Giemsa and trephine biopsieswere stained with and hematoxylin and eosin.Results: The majority of patients were from age group 29-38years (9 cases). Male to female ratio was 1.5:1. Commonestcomplaint presented was weakness in 28 cases followed byfever in 21 cases. Other presenting complaints were fatigue,breathlessness, icterus. Severe acute malnutrition was presentin 6 patients followed by malaria and dengue (5 cases each),Enteric fever in 2 patients. The most common cause ofPancytopenia was megaloblastic anaemia and was seen in 13cases. Bone marrow was hypercellular in all cases.Conclusion: Detailed physical examination; hematologicalinvestigations along with bone marrow aspiration andbone marrow biopsy wherever necessary in Pancytopenicpatients are helpful to diagnose or to rule out the causes ofPancytopenia.