Clinico-Etiological Profile and Outcome of Acute Febrile Illness with Thrombocytopenia in Children: A Hospital-Based Prospective Study.

Abstract

Background: Acute febrile illness (AFI) with thrombocytopenia is a common clinical condition in children, particularly in tropical countries where infections such as dengue, malaria, and scrub typhus are prevalent. Early identification of the underlying cause and appropriate management are important to reduce complications and mortality.

Objectives: To study the clinico-etiological profile and outcomes of acute febrile illness with thrombocytopenia in children admitted to a tertiary care hospital.

Materials and Methods: This hospital-based prospective observational study was conducted at Sri Siddhartha Medical College and Hospital, Tumkur, over a period of 24 months after obtaining ethical approval. A total of 57 children aged 1 month to 18 years admitted with acute febrile illness and thrombocytopenia were included in the study. Detailed clinical history, examination findings, and laboratory investigations, including complete blood count and peripheral smear, were recorded using a predesigned proforma. Thrombocytopenia was classified as mild, moderate, and severe based on platelet count. Data were analysed using MS Excel and EPI INFO version 7.2.5, and statistical analysis was performed using descriptive statistics and the chi-square test.

Results: The mean age of the participants was 8.85 ± 5.19 years, with the majority belonging to the 1–5 year age group (33.33%). Male children constituted 61.40% of the study population. Dengue was the most common etiological cause (36.8%), followed by malaria (33.3%), scrub typhus (17.5%), typhoid fever (7%), and sepsis/others (5.3%). Mild thrombocytopenia was observed in 56.10% of cases, moderate in 38.60%, and severe in 5.30%. Hepatomegaly was present in 71.90% and splenomegaly in 22.80% of patients, while bleeding manifestations were seen in 17.50%. Most children recovered completely (68.43%), 28.07% recovered with complications, and mortality was 3.50%. No statistically significant association was found between the severity of thrombocytopenia and outcomes (p = 0.451).

Conclusion: Dengue, malaria, and scrub typhus are the leading causes of acute febrile illness with thrombocytopenia in children. Most patients recover with timely diagnosis and appropriate treatment. Early recognition and management are essential to reduce complications and improve outcomes.