A 33-year-old man is on day 5 of dengue fever with warning signs and is receiving careful intravenous fluids. His haematocrit is stable over serial measurements, vital signs are normal, and there is no mucosal bleeding. Today his platelet count is 12,000/uL. What is the appropriate action regarding platelet transfusion?

• A Transfuse single-donor platelets immediately
• B Withhold transfusion and monitor clinically ✓
• C Transfuse fresh frozen plasma instead
• D Give intravenous immunoglobulin to raise the count

Explanation

Prophylactic platelet transfusion is not indicated in dengue unless the count falls below approximately 10,000/uL in a stable patient without bleeding, or earlier if there is active haemorrhage or very rapid fall. Transfused platelets are rapidly destroyed by the ongoing immune-mediated process and confer no bleeding benefit. The decisive management is serial haematocrit-guided fluid therapy, and counts recover spontaneously during the recovery phase.

Reference: WHO Guidelines for Diagnosis, Treatment, Prevention and Control of Dengue, 2009 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.