scholarly journals A Clinical Study of the Association of Thrombocytopenia with Acute Febrile Illness

2022 ◽  
Vol 9 (3) ◽  
pp. 12-15
Author(s):  
Gangum Venkatreddy ◽  
Shireesha Gugloth
Keyword(s):  
Platelet Count ◽  
Enteric Fever ◽  
Viral Infections ◽  
Clinical Signs ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Platelet Counts ◽  
Chest X Ray ◽  
The Common ◽  
Time Of Admission

Abstract Background: Thrombocytopenia accompanying acute febrile illnesses is a matter of concern because lack of prompt treatment could result in significant mortality. We in this study tried to evaluate the clinical profile of cases with acute fever and thrombocytopenia and determine the cause of fever with thrombocytopenia and the outcome of treatment of such patients in our hospital. Methods: A total of n=50 successive cases of acute febrile illness with thrombocytopenia following inclusion and exclusion criteria were included in this study. Clinical signs such as rashes, signs of dehydration, petechiae, jaundice, lymphadenopathy, hepatomegaly, splenomegaly, anemia, abdominal tenderness, altered sensorium, were noted. Investigations included CBP, ESR, LFT, RFT, serum electrolytes, Chest X-ray, USG abdomen were done. Other investigations included Dengue serology, Malaria, Widal, IgM for leptospirosis, sputum for AFB. Results: Out of n=50 patients with acute fever with thrombocytopenia, all of them had a definitive diagnosis with malaria (40%) as the commonest cause, followed by enteric fever (24%), viral fever (14%), septicemia (6%), dengue (14%), and leptospirosis (2%). 50% of the patients had platelet count in the range of 50, 000 – 1,00, 000 and 30% had platelet counts above 100000-150000. 8% of cases had platelet counts below 25000 and 12% had platelet counts between 25000-50000 at the time of admission. 10% mortality was observed. Conclusion: infections as the commonest cause of thrombocytopenia. Malaria, dengue enteric fever, leptospirosis, and other viral infections formed the major diseases in this group of population. The diagnosis of malaria was the common cause because of seasonal and regional variations. A definitive increase in platelet count was noted after the underlying cause was treated. Severe cases of septicemia with associated co-morbidities resulted in mortality.

scholarly journals Diagnostic Value of Clinical Features to Distinguish Enteric Fever From Other Febrile Illnesses in Bangladesh, Nepal, and Pakistan

2020 ◽  
Vol 71 (Supplement_3) ◽  
pp. S257-S265 ◽  
Author(s):  
Kristen Aiemjoy ◽  
Dipesh Tamrakar ◽  
Shampa Saha ◽  
Shiva R Naga ◽  
Alexander T Yu ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Features ◽  
Diagnostic Performance ◽  
Enteric Fever ◽  
Random Effect ◽  
Clinical Signs ◽  
Febrile Illness ◽  
Diagnostic Value ◽  
Case Definition ◽  
Mixed Effect

Abstract Background Enteric fever, a bacterial infection caused by Salmonella enterica serotypes Typhi and Paratyphi A, frequently presents as a nonlocalizing febrile illness that is difficult to distinguish from other infectious causes of fever. Blood culture is not widely available in endemic settings and, even when available, results can take up to 5 days. We evaluated the diagnostic performance of clinical features, including both reported symptoms and clinical signs, of enteric fever among patients participating in the Surveillance for Enteric Fever in Asia Project (SEAP), a 3-year surveillance study in Bangladesh, Nepal, and Pakistan. Methods Outpatients presenting with ≥3 consecutive days of reported fever and inpatients with clinically suspected enteric fever from all 6 SEAP study hospitals were eligible to participate. We evaluated the diagnostic performance of select clinical features against blood culture results among outpatients using mixed-effect regression models with a random effect for study site hospital. We also compared the clinical features of S. Typhi to S. Paratyphi A among both outpatients and inpatients. Results We enrolled 20 899 outpatients, of whom 2116 (10.1%) had positive blood cultures for S. Typhi and 297 (1.4%) had positive cultures for S. Paratyphi A. The sensitivity of absence of cough was the highest among all evaluated features, at 65.5% (95% confidence interval [CI], 55.0–74.7), followed by measured fever at presentation at 59.0% (95% CI, 51.6–65.9) and being unable to complete normal activities for 3 or more days at 51.0% (95% CI, 23.8–77.6). A combined case definition of 3 or more consecutive days of reported fever and 1 or more of the following (a) either the absence of cough, (b) fever at presentation, or (c) 3 or more consecutive days of being unable to conduct usual activity--yielded a sensitivity of 94.6% (95% CI, 93.4–95.5) and specificity of 13.6% (95% CI, 9.8–17.5). Conclusions Clinical features do not accurately distinguish blood culture–confirmed enteric fever from other febrile syndromes. Rapid, affordable, and accurate diagnostics are urgently needed, particularly in settings with limited or no blood culture capacity.

scholarly journals Incidental Detection of Dent-2 Disease in an Infant with Febrile Proteinuria

2018 ◽  
Vol 27 (4) ◽  
pp. 392-395 ◽  
Author(s):  
Shpetim Salihu ◽  
Katerina Tosheska ◽  
Svetlana Cekovska ◽  
Velibor Tasic
Keyword(s):  
Molecular Weight ◽  
Sodium Dodecyl Sulfate ◽  
Clinical Presentation ◽  
Viral Infections ◽  
Sodium Dodecyl ◽  
Febrile Illness ◽  
Low Molecular Weight ◽  
Acute Febrile Illness ◽  
Low Molecular Weight Proteinuria ◽  
Sds Page

Objective: Febrile proteinuria is functional proteinuria and is seen as a transitory phenomenon during acute febrile illness, mainly viral infections. It is a benign phenomenon and clears promptly with resolution of the infection. Clinical Presentation and Intervention: In this report, we present a patient who was thought to have febrile proteinuria. Persistence of significant proteinuria after resolution of the infection prompted biochemical and genetic workup which led to the diagnosis of Dent-2 disease. Conclusion: We recommend the use of SDS-PAGE (sodium dodecyl sulfate electropheresis) for the detection of low molecular weight proteinuria.

scholarly journals Long-term, intermittent, low-level elephant endotheliotropic herpesvirus 1A viremia in a captive Asian elephant calf

2018 ◽  
Vol 30 (6) ◽  
pp. 917-919 ◽  
Author(s):  
Kendra L. Bauer ◽  
Erin Latimer ◽  
Mitch Finnegan
Keyword(s):  
Platelet Count ◽  
Clinical Signs ◽  
Asian Elephant ◽  
Elephas Maximus ◽  
Conventional Pcr ◽  
Low Level ◽  
Platelet Counts ◽  
Additional Information ◽  
Time Period

A 2-y-old male Asian elephant ( Elephas maximus), with an elevated platelet count (1,100 × 109/L [1,100 × 103/mm3]), tested positive for elephant endotheliotropic herpesvirus 1A (EEHV-1A) on conventional PCR (cPCR) of EDTA whole blood. No clinical signs were ever reported and no treatment was administered, but low-level viremia persisted for 2.5 y based on results of cPCR and/or real-time PCR (rtPCR). Sequencing confirmed that the EEHV-1A detected was identical at the beginning through the end of the time period. No other elephants in the herd tested positive for EEHV-1 during this time period. Platelet counts remained elevated throughout the viremia and throughout the animal’s life, and direct correlation between the elevated platelet counts and EEHV-1A viremia could not be confirmed. We document long-term, intermittent, low-level viremia of EEHV-1A and provide additional information to consider when determining if treatment is warranted in a case of EEHV infection.

Study of acute febrile illness with low platelet count

2019 ◽  
Vol 10 (1) ◽  
pp. 33-37
Author(s):  
Haresh Panchal ◽  
◽  
Urvesh Mistry ◽  
Keyword(s):  
Platelet Count ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Low Platelet Count

scholarly journals Healthcare Utilization Patterns for Acute Febrile Illness in Bangladesh, Nepal, and Pakistan: Results from the Surveillance for Enteric Fever in Asia Project

2020 ◽  
Vol 71 (Supplement_3) ◽  
pp. S248-S256 ◽  
Author(s):  
Jason R Andrews ◽  
Krista Vaidya ◽  
Shampa Saha ◽  
Mohammad Tahir Yousafzai ◽  
Caitlin Hemlock ◽  
...  
Keyword(s):  
Disease Severity ◽  
Enteric Fever ◽  
Febrile Illness ◽  
Household Wealth ◽  
Acute Febrile Illness ◽  
Care Seeking ◽  
Mixed Effect ◽  
Healthcare Seeking ◽  
The Past ◽  
Catchment Areas

Abstract Background Characterizing healthcare-seeking patterns for acute febrile illness is critical for generating population-based enteric fever incidence estimates from facility-based surveillance data. Methods We used a hybrid model in the Surveillance for Enteric Fever in Asia Project (SEAP) to assess incidence of enteric fever at 6 study hospitals in 3 countries. We recruited individuals presenting to the hospitals and obtained blood cultures to evaluate for enteric fever. For this analysis, we undertook cluster random household surveys in Dhaka, Bangladesh (2 sites); Karachi, Pakistan; Kathmandu, Nepal; and Kavrepalanchok, Nepal between January 2017 and February 2019, to ascertain care-seeking behavior for individuals with 1) fever for ≥3 consecutive days within the past 8 weeks; or 2) fever resulting in hospitalization within the past year. We also collected data about disease severity and household demographics and assets. We used mixed-effect multivariable logistic regression models to identify determinants of healthcare seeking at study hospitals and determinants of culture-confirmed enteric fever. Results We enrolled 31 841 households (53 926 children) in Bangladesh, 25 510 households (84 196 children and adults) in Nepal, and 21 310 households (108 031 children and adults) in Pakistan. Children <5 years were most likely to be taken to the study hospitals for febrile illness at all sites. Household wealth was positively correlated with healthcare seeking in 4 of 5 study sites, and at least one marker of disease severity was positively associated with healthcare seeking in 3 of 5 catchment areas. Wealth and disease severity were variably predictive of blood culture-confirmed enteric fever. Conclusions Age, household wealth, and disease severity are important determinants of healthcare seeking for acute febrile illness and enteric fever risk in these communities, and should be incorporated into estimation models for enteric fever incidence.

scholarly journals COMPARATIVE ASSESSMENT OF ICT,WIDAL WITH BLOOD CULTURE FOR THE DIAGNOSIS OF TYPHOID FEVER AMONG PUO CASES IN A TERTIARY CARE: A HOSPITAL BASED STUDY OF NORTH EAST.

2020 ◽  
pp. 19-20
Author(s):  
Banti Das ◽  
Niladri Sekhar Das
Keyword(s):  
Blood Culture ◽  
Disease Burden ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Comparative Assessment ◽  
Acute Febrile Illness ◽  
North East ◽  
Laboratory Confirmation ◽  
Tropical Areas

Background: Disease burden of acute febrile illness due to infectious etiologies is under reported in various parts of India including North east due to lack of laboratory confirmation. Undifferentiated febrile illnesses common in tropical areas of Asia and enteric fever is one of them Aims: This study was conducted to determine the best investigative procedures for the diagnosis of enteric fever . Setting and Design: This was a hospital based study among 205 patients including paediatric patients admitted with acute febrile illness were evaluated by ICT, Widal and Blood culture Materials and Methods: ICT , Widal and blood culture were performed according to manufactuter instruction Results: When ICT was compared to blood culture concordence rate was found to be 92% where as discrepacancy was just 8% and sensitivity and specificity was found to be 100 % and 90.24%.

scholarly journals Platelet count and AST can reliably predict the onset of plasma leakage in dengue, a low-cost triage tool during epidemics

2019 ◽  
Author(s):  
Arjuna Medagama ◽  
Chamara Dalugama ◽  
Gukes Meiyalakan ◽  
Darshani Lakmali
Keyword(s):  
Platelet Count ◽  
Health Care Services ◽  
Viral Infections ◽  
Low Cost ◽  
Febrile Illness ◽  
Final Analysis ◽  
Hemorrhagic Fever ◽  
Severe Dengue ◽  
Upper Limit ◽  
Plasma Leakage

Abstract Background: Dengue is one of the most important mosquito-borne viral infections to affect humans. It is most often a self-limiting febrile illness but in some instances can progress to plasma leakage and in extreme cases culminate in death. Dengue is endemic in Sri Lanka and 2017 saw the largest outbreak on record with over 160,000 cases and over 300 deaths. Health care services reached its’ limits coping with this epidemic. The objective of this study was to identify reliable, low-cost, easily-accessible and objective predictors of Dengue hemorrhagic fever (DHF) that can be used as a triage tool in epidemic situations. Methodology/Principal findings: Serologically confirmed 350 serial adult dengue patients were included in the study. 257 (73.4%) were classified as dengue fever (DF, non leakers) and 93 (26.5%) as DHF with plasma leakage. Bedside ultrasonography was used to identify plasma leakage. Bivariate and regression analysis showed platelet count (Pearson r 0.59), and AST (r 0.27) to be significantly correlated with plasma leakage and platelet count to have a moderate predictive association (R2 0.35) with plasma leakage. Platelet count <50,000/mm3 (OR 23.7; 95% CI 12.2-45.9), AST> twice, upper limit of normal (OR 7.5; 95% CI 3.9-14.3) and ALT> twice, upper limit of normal (OR 2.4; 95%CI 1.4-3.6) increased the likelihood of DHF. In the final analysis, logistic regression identified platelet count <50,000/mm3 (OR 17.2; 95% CI 8.6-34.1) and AST>2ULN (OR 5.1, 95% CI 2.1-12.1) at time of plasma leakage as significant independent predictors of DHF. ROC curve performed for Platelet count had an AUC of .89 and at a platelet count of 50,000/mm3 predicted DHF with a sensitivity of 87% and specificity of 79%. AUC for AST was 0.72 and at 93Iu/L predicted DHF with a sensitivity of 85% and specificity of 60%. Conclusion: We have identified 2 laboratory parameters that could be used to identify plasma leakage and might be useful to stratify dengue-infected patients at risk for developing severe dengue.

A PROSPECTIVE STUDY ON VARIOUS SEROLOGICAL MARKERS AND PLATELET COUNT IN DENGUE INFECTION IN AND AROUND KANCHEEPURAM.

2021 ◽  
pp. 45-46
Author(s):  
Hamsadwani K P ◽  
Sneka P ◽  
Sangamithra V
Keyword(s):  
Platelet Count ◽  
Dengue Infection ◽  
Febrile Illness ◽  
Antibody Detection ◽  
Serological Markers ◽  
Serum Samples ◽  
Platelet Counts ◽  
Acute Viral Infection ◽  
Ns1 Antigen ◽  
A Prospective Study

INTRODUCTION: Dengue is an acute viral infection with potential fatal complications, presenting with non-specic fever that mimics other febrile illness. Specic antibody detection has been the mainstay of diagnosis which is prone for false positive and negative reactions. The newer parameter NS1 appears to be highly specic and reliable for diagnosis. Therefore, we tried to evaluate the association of platelet counts against NS1 and IgM / IgG in dengue infections. OBJECTIVE: To study the association of thrombocytopenia with NS1 antigen and specic antibodies in dengue infection in kancheepuram population. MATERIALS AND METHODS: Serum samples from clinically suspected dengue cases were tested for NS1,IgM,IgG by immunochromatography – based test. Platelet counts were obtained from all positive cases. Test results of dengue-specic parameters and platelet counts were compared. RESULTS: Of the 612 samples tested, 150 were positive for one or more dengue serological markers. Of the 150, 27(18%) were positive for NS1only, 45(30%)were positive for IgM, 54(36%) were positive for IgG only. Of the 150, 39(26%) showed platelet count less than 1 lakh. CONCLUSION: Inclusion of NS1 in the diagnosis of dengue increases the detection and specicity rate. Thus correlation of platelet count, NS1,IgM and ,IgG gives detailed picture of the stage and prognosis of the disease

scholarly journals Huge yolk sac tumor in an adolescent girl: a case report

2017 ◽  
Vol 6 (7) ◽  
pp. 3192
Author(s):  
Amrita J. Jain ◽  
Rekha G. Daver ◽  
Anjali M. Patil
Keyword(s):  
Febrile Illness ◽  
Yolk Sac ◽  
Final Outcome ◽  
Acute Febrile Illness ◽  
Age Group ◽  
Aggressive Disease ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
The Common ◽  
Yolk Sac Tumour

Germ cell tumours form a minority of all malignancies of the ovary. The common age group affected by yolk sac tumours is 11 to 24 years. Here, we present a case of yolk sac tumour in a 13-year-old girl who came with complaints of abdominal pain, distension and acute febrile illness. Fertility sparing surgery (Unilateral salpingo-oophorectomy) was done while the contra lateral ovary and uterus was conserved followed by combination chemotherapy postoperatively. As pprognosis of yolk sac tumours is highly stage-dependent, an early diagnosis can result in a drastic difference in the final outcome of the treatment of this highly aggressive disease. Besides the rarity of the tumour, the importance of the fact, that a vigilant and informed clinician can make an early and timely diagnosis of this condition even in girls of such a young age and make a drastic difference in the final outcome of the treatment, compels us to present this case.

scholarly journals A study on clinical profile of acute undifferentiated febrile illness in a tertiary care hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 404
Author(s):  
Mariraj I. ◽  
Mohammed Adil ◽  
Ramkumar M. ◽  
Jagadeesan M. ◽  
Prasanna Karthik S. ◽  
...  
Keyword(s):  
Enteric Fever ◽  
Scrub Typhus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Clinical Profile ◽  
Malarial Parasite ◽  
Care Hospital ◽  
Acute Febrile Illness ◽  
Function Test

Background: Acute febrile illness is very common among patients seeking hospital care in tropical country like India. This study was conducted to evaluate etiology and clinical profile of Acute Undifferentiated Febrile Illness (AUFI) in a tertiary care hospital.Methods: This study was conducted in 175 patients with acute febrile illness who were admitted in the medical wards and ICU from January 2018 to June 2019 in a tertiary care hospital. Clinical examination and investigations like complete hemogram, liver function test, renal function test, smear for malarial parasite, widal test, urine analysis blood and urine culture, antibody titters for dengue, Leptospirosis and imaging were done.Results: Out of 175, 94 (54%) were males and 81 (46%) were females. The commonest etiology was dengue (19%) followed by enteric fever (18%), scrub typhus (16%), malaria (14%), tuberculosis (6%) and leptospirosis (5%). 138 (79%) patients had less than 14 days of fever of which dengue was the most common and 37 (21%) patients had more than 14 days of fever with tuberculosis being predominate. Other common symptoms were chills/rigors, headache and myalgia seen in 77%, 71% and 42% respectively. Icterus was seen in malaria (42%) and leptospirosis (38%). Elevated transaminases levels were observed with dengue, leptospirosis, scrub typhus, enteric fever and malaria. ARDS was most common in scrub typhus.Conclusions: Among acute febrile illness, dengue and enteric fever were the most common in this study. A thorough and probing search for an eschar is very important in scrub typhus. The treating physician has to keep in mind the comprehensive list of differential diagnosis for patients with febrile illness and anticipating the complications.

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