A 25-year-old man with dengue fever is on day 4 of illness. His platelet count is 35,000/μL, hematocrit is stable at 40%, and he is hemodynamically stable with no warning signs. He requests platelet transfusion. What is the most appropriate management?

• A Transfuse 4 units of random donor platelets immediately
• B Transfuse single donor platelets prophylactically to prevent hemorrhage
• C Administer intravenous immunoglobulin to boost platelet count
• D Do not transfuse platelets; monitor clinically and with serial hematocrit ✓

Explanation

Prophylactic platelet transfusion is NOT recommended in dengue regardless of platelet count in the absence of active bleeding or other indications. WHO guidelines state platelet transfusion is only for severe active bleeding. Thrombocytopenia in dengue is self-limiting. Unnecessary transfusion risks transfusion reactions, volume overload, and does not prevent hemorrhage. IVIG has no role in dengue thrombocytopenia.

Reference: National Vector Borne Disease Control Programme (NVBDCP) Guidelines, 2023 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.