1Department of Paediatrics, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Puducherry.
Background: Thrombocytopenia, which raises the risk of bleeding and indicates the severity of the illness, frequently complicates acute febrile illness (AFI), a leading cause of paediatric admissions. Infections including dengue, malaria, typhoid, and scrub typhus frequently produce this dual presentation, although autoimmune diseases, hematological abnormalities, or drug-induced reasons can also cause it. Management is difficult because to overlapping symptoms and poor diagnostics, particularly in endemic areas. For the purpose of directing treatment and averting complications, early detection of thrombocytopenia in children with fever is essential. To enhance diagnostic techniques, treatment plans, and medical responses in high-burden environments, targeted study on clinical profiles and outcomes is required.
Aim and Objectives: This study aims to evaluate the clinical profile and outcomes of children aged 1 month to 18 years admitted with acute febrile illness and thrombocytopenia at a tertiary care center in Puducherry. The objectives are to describe clinical presentations, identify infectious and non-infectious etiologies, and correlate the severity of thrombocytopenia with disease outcomes.
Materials and Methods: In this cross-sectional study, 266 children with acute febrile illness and thrombocytopenia, ages 1 month to 18 years, were enrolled in the paediatrics department of a tertiary care hospital in Puducherry between June 2023 and June 2024. A thorough history, clinical examination, and pertinent tests (CBC, peripheral smear, renal/liver function tests, malaria RDT, dengue serology, scrub typhus IgM, Widal, blood cultures, chest X-ray, MRI for probable encephalitis) were carried out following informed consent and assent. Transfusions were administered for severe thrombocytopenia or bleeding, and platelet counts were tracked until they returned to normal. Malaria, dengue, scrub typhus, enteric fever, leukemia/ITP, septicemia, viral encephalitis, and undetected fever were among the diagnoses.
Results and Discussion: The clinical profile and results of paediatric patients with acute fever and thrombocytopenia are highlighted in this study. The most common causes were scrub typhus and dengue fever, highlighting the significance of regional epidemiology in directing diagnosis. The majority of patients had minor thrombocytopenia, a good prognosis, a high rate of recovery, and little need for transfusions. Severe thrombocytopenia, however, was linked to extended hospital admissions and sporadic organ malfunction, highlighting the necessity of continuous observation and critical treatment in these situations. In endemic areas, serological tests—specifically, dengue IgM and scrub typhus IgM—proved useful in making diagnoses. The significance of a thorough organ function assessment was highlighted by anomalies in severe instances, even when liver and renal functions were generally conserved. Overall, from the results it is clear that it is difficult to treat paediatric febrile thrombocytopenia and emphasize the need for immediate therapies, systematic diagnostic techniques, and additional research into risk stratification models and new biomarkers to enhance outcomes.
Keywords: Thrombocytopenia, acute febrile illness, scrub typhus, dengue fever, malaria.
How to cite this article: Lavaniya R, Kulandaivel M, Manoharan E, Malleswari, Gunalan A. A Cross-Sectional Study on the Clinical Profile and Outcome of Acute Febrile Illness with Thrombocytopenia in Children Aged 1 Month to 18 Years Admitted at Tertiary Care Centre, Puducherry. Int J Drug Deliv Technol. 2026;16(15s): 624-636. DOI: 10.25258/ijddt.16.15s.73
Source of support: Nil.
Conflict of interest: None