What are the common infections associated with fever and low platelets?
Dengue fever, Chikungunya, HIV, viral hepatitis, and EBV can cause this combination. Sepsis, scrub typhus, and malaria can be associated with these combinations as well.
What about blood disorders and low platelets?
Blood cancers or leukaemias, autoimmune low platelets disorders known as ITP, plastic anemia, and myelodysplasia disorders, and leukemias can be associated with low platelets and fever.
Can medications cause a lowering of platelets as a 3 part t of their side effects?
Certain antibiotics like Ampicillin, Piperacillin, sulpha drugs, and epilepsy drugs like Phenytoin, Carbamazepine, Valproic acid, heparin, Clopidogrel, Ibuprofen, and Naproxen can cause low platelets. Drugs used in chemotherapy and monoclonal antibodies can cause low platelets. Omeprazole and certain vaccines can also lower the platelets.
What about other important causes?
Autoimmune disorders like lupus, enlarged spleen, severe vitamin B12 or Folic acid deficiency, DIC associated with septicemia, or malignancy can be associated with fever and low platelets.
How to know the causes of fever and low platelets?
This includes a history of recent travel, exposure to infections, medication history, and any previous bleeding tendencies. Look for signs of enlarged spleen, lymph nodes, and purpuric spots.
Are there drugs to stimulate platelet counts?
Orally given Eltrombopag, injectable Romiplostim, steroids, immunoglobulins, and Rituximab may be considered under expert guidance only.
What about blood tests?
Complete blood tests including peripheral smear and see for clumping of platelets, liver and kidney function tests, and coagulation profile may become necessary. Tests for Dengue, Chikungunya, bone marrow examination including biopsy of bone marrow, tests for autoimmune disorders, and ultrasound of the abdomen or CT scans may be required.
How do you manage low platelets with fever?
Sometimes the diagnosis may become evident by simple blood tests and clinical examination. Dengue and Chikungunya are self-limiting disorders in most cases. A platelet count below 20,000 may require platelet transfusion. Above this, close vigilance with almost daily platelet counts may be essential. In viral infections, do not worry if the platelets go down even to 40,000. Most of the time management of underlying disease leading to low platelets is important. Treatment options In immune disorders, steroids, IV immunoglobulins, and other immunosuppressants may be helpful. Platelet transfusions are considered if platelets are low and bleeding from the nose, mouth, urine, or if obvious recolored spots on the skin.
