Hello doctor, My daughter, 21 years old, has a fever (100 degF to 101 degF) and nausea for the last five days. She has very low appetite and abdominal pain. Among all other tests, the CBC test worries me. The test result reveals that her WBC count is 3300, neutrophils 83 % and lymphocytes 11 %, platelet count 101000. Her RBC is 3.66 million, Hb 10.7 %. All other parameters including kidney and liver functions are normal. Doctors say that it is a viral infection, dengue. She has been advised to take Paracetamol, Omeprazole, B12 Vitamins and Fefol tablets and also to take plenty of water. Fever does not get subsided completely. Do you think giving antibiotics would help her at this stage? Could it be a bacterial infection too? The doctor did not prescribe any antibiotics. I need a second opinion from you.
Hi. I have read through your query in detail. Please find my observations below: Your daughter has slightly low hemoglobin and platelets (attachment removed to protect patient identity). The normal hemoglobin is considered above 12 and platelets more than 150000. RBC count is less and 4.5 million is normal. The total count is also less showing leucopenia, normally more than 4000 and the neutrophil percentage is more and lymphocytes percentage is less. There is NS1Ag (antigen) test showing positive which indicates the possibility of dengue infection. Rapid test and dengue ELISA (enzyme-linked immunosorbent assay) might appear negative now but will become positive after some time. Right now antibiotics are not required because there is no sign of bacterial infection. Fever will take time to respond and please give her Paracetamol after food every six hours for fever. Supportive care is important for dengue fever and that is the reason your doctor has prescribed Paracetamol for fever and pain and Omeprazole to prevent gastritis. Daily water and fresh juices should be two liters and diet should be 1800 kcal daily. It is still in a mild stage and regular platelet test is required for monitoring. The doctor might also tell to get ultrasound scan abdomen done to look for any water collection in the abdomen.