Platelet Count – A Diagnostic Aid In Fever

Abstract

Introduction: Vivax Malarial infection. Dengue Viral fever is also emerging as a Febrile conditions to have reduced platelet count. The absence of the normal platelet count on peripheral smear in case of fever is a clue to the presence of Malaria and Dengue fever. Material & Method: Present study we have tried to study the pattern of thrombocytopenia in these febrile conditions and their diagnostic and prognostic implications. The study was conducted at GMERs Medical College, Gandhinagar. This study group consisted of 146 Patients of Fever treated at Pediatric Department, Malaria diagnosed by thick & thin smear examination. The platelet count was done by Abascus Junior B- Blood Cell counter. Dengue Fever was diagnosed by NS1 Antigen Test. The Mean Platelet counts in P. Falciparum are 69852 cells/mm3, P.Vivax 1,15,580 and Dengue Fever 53,100. Statistically the difference between P. Falciparum & Vivax is significant for differentiating Malarial type. Result: Platelet count <20,0000 cells/mm3 was observed in both the types of Malaria and not seen with Dengue Fever. Profound thrombocytopenia still remains the distinguishing, feature of P. Falciparum Malaria. Platelet count more than 1,00,000 cells/mm3 favours the diagnosis of P.Vivax & Moderate reduction in Platelet Count (between 20,000 to 1,00,00) is clue to P. Falciparum and Dengue Fever. In this segment other diagnostic criteria like pFHrp Antigen and N.S.Antigen should be applied to differentiate these two grave conditions. Thrombocytopenia (Platelet count <150000 cells/mm3) can be considered as a predictor of Malaria and in combination with Anemia (Hb<10gm/dl) is a next best parameter. Unlike Malaria, in Dengue fever thrombocytopenia is usually associated with normal Hemoglobin.