Having Fever With Continuous Headache. Took Paracetamol. Blood Test Showed Decreased Leucocytes

Posted on Thu, 21 Nov 2013

Question: Hi Doctor,

I am having fever from last 6 days with continuous headache. I am having paracetamol on regular interval but my fever is not decreasing from 100 degree, sometimes it reaches to 103 degree as well, Because of fever my appetite is also reducing day by day.

I got it checked from doctor and she suggested me to get some blood test done.

On 8 th Oct My my Leucocytes count was 4200 (Normal Range- 4000-0000 cu.mm) and my Platelets count was 1.85 (Normal Range - 1.5-4.5 Lakh/cu.mm), But on 11th Oct my my Leucocytes count was decreased to 3800 from 4200 and platelet count 1.42 from 1.85.

Then i had
Dengue Antibody IGM - Not Detected
Dengue Antibody lgG- Not Detected
Dengue NS1 Antigen - Negative
Malaria Parasite/Blood Parasite Identification - No MP Seen in smears examined.

Then i had Complete Blood Count Test, There
RBC Count is showing low - Current is 4.24 (Normal - 4.50-5.50)
MCH is showing High - 33.70 (Normal - 27.00-32.00)
MCHC is showing high - 35.80 (Normal - 32.00-35.00)
Red Cell Distribution Width is high- 15.20 (Normal - 11.50-14.50)

Differentiaql Lecocyte Count (DLC)
Eosinophils is showing NILL-0.00 (Normal 1.00-6.00)

Absolute Leucocyte Count
Eosinophills is showing NILL - 0.00 (Normal 0.02-0.50)

Its been 6 days and i am still having fever, kindly suggest what could be the reason? please also help me understanding that if i dont have dengue, why my platelets count is decreasing.

Regards

Answered by Dr. Manjeth Kumar G (2 hours later)

Brief Answer:
Bacterial or Drug. Do blood and urine culture

Detailed Answer:
Hello,
Welcome to XXXXXXX

Thanks for your query.
I have gone through your query and understand your concern.

There are few causes other than dengue to have decreased platelet count with fever.
1. Bacterial infections.
Severe bacterial infections involving the blood (bacteremia) may lead to destruction of platelets.
Please consult your treating doctor regarding further possibility of bacterial infection. If possible do blood and urine culture.
2. NSAIDS and Antibiotics.
Certain NSAIDS and Antibiotics like Sulfa containing drugs confuse immune system by forming the drug- platelet complex resulting in destruction of platelets.
Review the currently taking drugs with your physician.
3. Delaying the collected sample to analyse.
Since the life time of platelet is only 10 days. destruction of siginficant amount of platelets by delay in analyzing may the cause for decreased platelets.

I advise you have thorough physical examination followed by Blood culture and urine culture now to identify the other possible bacterial infection.

Hope this helps.
Please reply for further queries.
Wishing you good health.

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Above answer was peer-reviewed by : Dr. Raju A.T