To Dr. Sarala Rajajee, Kanchi Kamarkoti Child Trust Hospital, Respected Madam, This patient initially came with fever for three days, had H/O Epistosis and the patient was admitted. On admission, SpO, Lo, NO glands blood count 21,800 (N65 L31%, platelet count 0.08%. Patient improved with platelet transfusion and IV antibiotic, Monocef, (500mg) IV BD (20.11.5005). The patient present with discharge of blood orally and with stool. Patient again on 08.12.2005 had fever and convulsion, on admit malaria vivax was +ve. Blood count within normal limit, PBS -> no abnormal cell. Platelet count 69,000. This time platelet improved without any transfusion and antimalarial drug was given and the fever subsided within two days (80,000 platelet) which improved to 2,74,000. Again on the 4th of January the platelet count came down to 1,60,000. Kindly inform me about the subsequent course of treatment.
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Pediatric Oncall replies: Since the platelet count is still in the normal range and the child is aymptomatic, one may wait and followup. If the platelet count decreases again, she needs to be evaluated for ITP and leukemia. ALso confirm the platelet adequacy on peripheral smear.
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