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Dr. Andrew Rynne

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Have fever, body pain and low platelet count. Advice some medicine

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Dr. Shanthi.E

General & Family Physician

Practicing since :2005

Answered : 2408 Questions

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Posted on Sat, 22 Dec 2012 in Blood Disorders
Question: Hello Doctor,

My father has a low platelet count. Count has reduced from 1 lakh 13 thousand to 80 thousand.

Please advise. he is already under doctor observation(hospitalized). Doctor has mentioned that its a sign of increase in platelet. he had a fever , body pain but it has been reduced now. even BP & other stiff is norms.

Kindly advise for increase in platelet & how to increase it. Many of my friends suggested for papaya leaf juice.since already other medication is going on will that papaya leaf juice will create any problem.
doctor
Answered by Dr. Shanthi.E 9 hours later
Hi,

I understand your concern towards your father, thanks for writing in.

The symptoms in your father of fever, body pain together with a low platelet count points towards viral hemorrhagic fever, most commonly Dengue fever. There is nothing to panic though!

Please note that a platelet count of 80,000 is expected in most viral illnesses like Dengue. It is not a XXXXXXX sign. We need to worry or act carefully if there is consistent drop in the platelet count lesser than 20,000.

Do repeat the platelet counts every alternate day to look for rise in the count. I assume that the dengue IgG and IgM antibodies are done in your father.

I am glad that is he under medical care; he shall improve soon.

The platelet count will increase on its own; nothing needs to be done at a count of 80,000. If it drops below 30,000 to 20,000, direct platelet transfusion may be given. You can speak to his treating doctor about this.

I am sorry, but there is no medical evidence on the use of papaya leaf juice in Dengue.

I wish your father an early recovery.

Do write back for follow up queries that you may have.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanthi.E 8 minutes later
Hi Doctor,

Thanks for your reply,

On the first day of the treatment in hospital, the Platelet count was 1,13,000 & suddenly decreased to 80,000. there is a difference of 0000 even when are giving proper treatment. Do we need to check for some other hospital. Doctor was saying that usually platelet count decreases at the beginning & then it will gradually increase.

father is looking so tired, what sort of food is advisable. Heard that orange juice has a good fight against fever will it work for dengue also. please suggest for food. For the past four days, he only had idly & rice water. is that reason for decrease in platelet.

Please do reply asap.
doctor
Answered by Dr. Shanthi.E 13 minutes later
Hi,

In viral fevers like Dengue, a drastic change in the platelet count is seen. That is why it is mostly done twice daily (morning and evening with 12 hours gap in between) in the hospital set up.

A wide range of variation is usually seen and the difference in the count may vary as much as 50,000 in two readings within 12 hours. Therefore, your father had a difference of 30,000, which is expected. As long as his platelet count does not drop below 50,000, he is fine.

In my opinion, there is no need to check into other hospital. I agree with his doctor that platelet count decreases initially and will improve gradually. Trust his doctor.

Dengue is one such viral fever where in there is a lot of tiredness, fatigue and malaise, whatever we may take it as. This tiredness or weakness will take a minimum of 3 months to go away completely.

Consider giving him bland diet, like idly and rice water as you are giving now. Do not give him spicy and oily food, and foods like Roti, which would be difficult to digest.

Upma, rice porridge, oats, idlis, plain rice and dal are good. Yes, orange juice will definitely help him. All citrus fruits like orange, sweet lime, lime, will help him heal faster. Give him plenty of fluids orally. Tender coconut water is good as well. Make sure he drinks at least 4 liters of fluids daily.

The decrease in platelet count is because of the viral fever and not due to idly and rice water.

Hope I have clarified your doubts, do write back if you need more clarifications.

Regards,



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanthi.E 44 minutes later
Thanks a lot for your reply, Actually i was not pointing idly/rice porridge as a reason for decrease but those are nutrient less food, so i suspected.

I forget to mentioned that fever has subsided after paracetamol but night sweating happens a lot.During night , he is experiencing chillness sporadically.

I have planned to give him XXXXXXX tea, XXXXXXX orange ,tomato, pomegranate apart from idly & other stuff.(starting today). i was really worried why we haven't gave any fruits previous days.

I will ask his doctor to take a blood count for every 12 hours do i also ask him for bone marrow test not sure whether it has been already taken. Yesterday liver test & scanning were show good result.

My concern is even after fever subsided why there be problem happens with low platelet. My father also suspect that he is getting a blood while spiting saliva.


As you mentioned papaya leaf have no evidence. Will there be any harm if we provide one while giving him papaya juice. (I would like to know will it be a problem if we provide while he is undergoing hospital medical treatment). Please let me the odds.

Awaiting for your reply.
doctor
Answered by Dr. Shanthi.E 39 minutes later
Hi,

In acute viral illnesses, simple calorie foods like idli and rice porridge are better as the workload on the liver is minimal in digesting them. They do not come in way of the platelet counts.

Night sweats are typical in Tuberculosis. How long has this been? If this is lasting for less than a month, then it is probably due to the viral fever itself rather than being Tuberculosis. Has he lost significant weight in recent times?

You can give him all the foods that you have planned to give your father. Add tender coconut water to the list.

Since the platelet count now is 80,000, it is not required to do it every 12 hours. It may be done every day or every alternate day. That should be fine.

There is absolutely no need for a bone marrow test now. I see that your father is improving with normal liver test and scan.

The natural history of the disease is like this - Fever will subside first, platelet will come to normal levels within 10 to 14 days, joint pain subsides by 3 weeks, the malaise or tiredness takes 3 months to go away.

Platelet count will improve in the next few days.

If a chest x-ray has not been done until now, it is better to get one done to rule out Tuberculosis.

You can give him papaya juice but I would not suggest the papaya leaf as it might come in the way of medical treatment.

Hope this helps.

Regards,




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanthi.E 12 hours later
Thanks a lot for the suggestion after following the mentioned diet, today we have taken a blood report & platelet count has increase back to 1,14,000.

Doctor has also concluded that my dad can be discharged from the hospital. I have a question here, count above 1,50,000 is normal rite..

since there is an increase in platelet, will it be constantly increasing. are there any odd chance that platelet would decrease.

whether we can follow the same diet mentioned above for the rest of the day till the count reaches 1,50,000. Please suggest me about intake of crab soup/chicken liver or fish that could increase the level of count.

is that good if we have a papaya juice before going to sleep?
doctor
Answered by Dr. Shanthi.E 11 hours later
Hi,

Good to know that the platelet count is increasing. Yes, you are right. The normal platelet count is 1,50,000. Your dad is improving well. Please continue the same diet for next 3 weeks.

There may still be a variation in the count by ~0000 over next few days. but he Will definitely improve.....

You can safely get him discharged from the hospital.

I Will not suggest all the three- crab soup, chicken soup and liver soup because all three are animal proteins. They can cause allergy and may not suit his current health status.

Follow my earlier suggestions.

I wish your father quick recovery.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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