Incidence of reactive thrombocytosis in serious bacterial infections in children aged two months to twelve years and its usefulness as a predictor of serious bacterial infections
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Date
2020-03
Journal Title
Journal ISSN
Volume Title
Publisher
Medip Academy
Abstract
Background: The aims of the study were to estimate the incidence of reactive thrombocytosis(RT) among febrile children aged 2 months to 12 years and to identify any differences in age group and gender in mounting thrombocytosis as a response to infection, to identify if thrombocytosis occurred preferentially in any particular group of serious bacterial infections(SBI), to compare thrombocytosis with other parameters like total white cell count, C-reactive protein(CRP), cultures etc. and to assess the utility of platelet count as a potential predictor of serious bacterial infection.Methods: This was a prospective study done in Institute of Child Health and Hospital for children, Madras Medical College from September 2015 to July 2016. Inclusion criteria: Children aged 2 months to 12 years with symptoms of fever less than 6 days admitted in the paediatric wards and those seen at the outpatient department. Exclusion criteria: Children having received parenteral antibiotics.Results: Of the 500 children, 142 (28.4%) had reactive thrombocytosis. RT was mild in 120 children (24%), moderate in 16 children (3.2%), severe in 4(0.8%) and extreme in two children (0.4%). This study showed that 36.48% (85 / 233) of children under 1 year had RT (p = 0.0002).There was no significant sex related difference in mounting RT. Out of 500 children included in the study, serious bacterial infection was diagnosed among 171 children (34.2%).Pneumonia (n=100) was the most common SBI followed by urinary tract infections (n=33), meningitis (n=23), sepsis (n=15). This study showed that RT has a moderate ability to predict serious bacterial infections (AUC=0.78; PPV-75.35%).Conclusions: Incidence of reactive thrombocytosis in febrile children aged 2 months to 12 years is 28.4%. It occurs more frequently in infants and without any sex predilection. RT is associated with leucocytosis, positive CRP, positive Chest X ray findings, positive urine culture and positive CSF findings. This shows that RT has a moderate ability in predicting SBI in children.
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Keywords
Empyema, Platelet count, Pneumonia, Predictor, Reactive thrombocytosis, Serious bacterial infection
Citation
Sadique Thahseen Nilofar Sahubar, Natarajan Thrilok, Shanmugham Kabilan, Veluchamy Suresh Kumar. Incidence of reactive thrombocytosis in serious bacterial infections in children aged two months to twelve years and its usefulness as a predictor of serious bacterial infections. International Journal of Contemporary Pediatrics. 2020 Mar; 7(3): 626-630