A 25-year-old returns from Southeast Asia with 3 days of high fever, retro-orbital headache, myalgia, and rash. CBC shows platelets 68,000/µL, WBC 2.8 × 10³/µL, hematocrit 42% (baseline 38% 6 months ago). NS1 antigen is positive. At what platelet count threshold does the WHO recommend platelet transfusion in dengue WITHOUT spontaneous bleeding?
- A <100,000/µL
- B Platelet transfusion is NOT recommended prophylactically in dengue ✓
- C <50,000/µL
- D <20,000/µL
Correct answer: B. Platelet transfusion is NOT recommended prophylactically in dengue
Explanation
WHO dengue guidelines do not recommend prophylactic platelet transfusion in dengue fever or dengue hemorrhagic fever without spontaneous significant bleeding, regardless of platelet count — even at very low counts. Platelet transfusion is only indicated for severe clinical bleeding. Prophylactic transfusions do not prevent bleeding episodes, are associated with fluid overload risk, and dengue platelets recover spontaneously as the disease resolves. IV fluid management to maintain perfusion is the cornerstone of dengue treatment.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.