Journal of Acute Care

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VOLUME 2 , ISSUE 2 ( May-August, 2023 ) > List of Articles


Fever with Thrombocytopenia—Look beyond Infection: A Case Report

Pooja C Patil, Aishwarya T Kulkarni, Pradeep M Venkategowda, Anand R Sutar

Keywords : Case report, Fever, Promyelocytic leukemia, Thrombocytopenia, Tropical infection

Citation Information : Patil PC, Kulkarni AT, Venkategowda PM, Sutar AR. Fever with Thrombocytopenia—Look beyond Infection: A Case Report. 2023; 2 (2):72-73.

DOI: 10.5005/jp-journals-10089-0071

License: CC BY-NC 4.0

Published Online: 30-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Patients having fever with thrombocytopenia [febrile thrombocytopenia (FT)] is a common observation in the intensive care unit (ICU). The majority of the cases of FT are infective in origin, and rarely, FT is due to a noninfectious cause. Case Description: This is a case of a 33-year-old male who presented with complaints of fever, myalgia, and loose stools. His routine blood investigation showed thrombocytopenia but was negative for tropical infection tests. The peripheral blood smear had blast cells. Bone marrow aspiration showed hypercellular marrow with blasts of occasional Auer rods. Flow cytometry revealed polymyelocytic (PML)/retinoic acid receptor alpha (RARA) fusion-M3 type of acute myeloid leukemia (AML). This patient was diagnosed as having acute promyelocytic leukemia (APML) and treated with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). Discussion: Febrile thrombocytopenia is one of the common causes of intensive care unit (ICU) admission. It narrows the differential diagnosis among patients admitted to the hospital. Tropical infections/sepsis are the major causes of FT. Hematological malignancies account for <1–2% of FT. Conclusion: This case highlights a rare cause of FT (due to APML). High suspicion of hematological malignancies in patients having FT and early initiation of treatment can reduce morbidity and mortality.

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