Clinical profile and outcome of fever with thrombocytopenia among children admitted at tertiary care hospital

Abstract

Background: Fever with thrombocytopenia is a common yet potentially serious clinical entity in paediatric patients in tropical countries, frequently associated with infections such as dengue, scrub typhus, enteric fever and septicaemia. This study aimed to describe the clinical profile and outcomes of such patients at a tertiary care hospital. Methods: A prospective observational study was conducted over 18 months (July 2023 to January 2025) in children aged 1 month to 12 years admitted with fever and thrombocytopenia. A total of 260 patients were enrolled using simple random sampling. Clinical data, laboratory investigations, treatment details and outcomes were recorded. Statistical analysis used SPSS version 16 (Chi-square test, Student’s t-test; p<0.05 considered significant). Results: The 6–10 years age group was most affected (40%), with male predominance (55%). Most participants were rural residents (65%) and admissions peaked during the monsoon (40%). Dengue fever (30%) was the most common identified aetiology; 46% remained undiagnosed. Severe thrombocytopenia was found in 47%. Overall mortality was 6.2%. Lower platelet counts (p<0.001), bleeding manifestations (p<0.002) and aetiologies of septicaemia and viral encephalitis (p=0.04) were significantly associated with mortality. Conclusions: Dengue and scrub typhus are the predominant identified aetiologies. Low platelet counts, bleeding manifestations, septicaemia and viral encephalitis are significant predictors of poor outcomes. Early recognition and prompt targeted management are vital to reducing morbidity and mortality in paediatric febrile thrombocytopenia.