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Hello Doctors, I Was Recently Exposed To Winter Weather, And

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Posted on Thu, 12 Dec 2019
Question: Hello Doctors,

I was recently exposed to winter weather, and also had some "oily food" outside the premises of my home. I was having fever from the past 5-6 days and I was taking the following medication:

(1) Encorate Chrono 500 mg (Sodium Valporate; twice a day, seizure disorder as prescribed by a Neurologist)
(2) Zolsoma 5mg (3-4 tablets a day as earlier I had worked in US shifts, as prescribed by a Psychiatrist)
(3) Multi- Vitamin tablet ( Zincovit)
(4) Dolo 650 (Paracetamol -- twice during day, at night my fever becomes 100-101, but not much chills or rashes etc
(5) Azithromycin Antibotic. 500 mg once per day. (for the flum throat infection)

Symptoms:

Prickling sensation in sternum area when I cough; dry cough.
yellowish/Green mostly flum.
Feverish feeling at night after the the Dolo (paracetamol medicine had elapsed its duration)

I had gone for a Complete Blood Panel Report today as well as viral, and hepatitis/HiV test.

All the tests had come out "negative" with the exception of the Dengue related thing for which I have some queries. (Typhoid, Malaria etc all negative)

I had earlier got this viral infection in Sept 2016, and probably developed some anti-bodies to this strain of virus.

Today's reports were

Dengue (Rapid Check)

Dengue NS1 Antigen-- Negative
Dengue IGM -- Negative
Dengue IGG-- Positive

Do I have dengue from the above results? The doctor said I don't have it but since it's a viral infection, the flu takes time to cure by itself.


CBP

WBC Count 5.9 (Biological Reference Level --> 4-10; Units--> 10 ^3/ul)

Platelet Count 130 (Units--> 10^3/ul; Biological Reference Level--> 150-400) (He said platelets slightly on lower side as well as WBC)

Rest of the CBP is fine.

He asked me to come after 1-2 days and get another CBP done and if platelets fall further, the next course of action can be taken.
He had said I don't have dengue but platelet and WBC count drop is due to flum and flu?

Can you folks please share your review/opinions? I would be mighty thankful.

Best Regards.
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Follow up: Dr. AJEET SINGH (0 minute later)
Hello Doctors,

I was recently exposed to winter weather, and also had some "oily food" outside the premises of my home. I was having fever from the past 5-6 days and I was taking the following medication:

(1) Encorate Chrono 500 mg (Sodium Valporate; twice a day, seizure disorder as prescribed by a Neurologist)
(2) Zolsoma 5mg (3-4 tablets a day as earlier I had worked in US shifts, as prescribed by a Psychiatrist)
(3) Multi- Vitamin tablet ( Zincovit)
(4) Dolo 650 (Paracetamol -- twice during day, at night my fever becomes 100-101, but not much chills or rashes etc
(5) Azithromycin Antibotic. 500 mg once per day. (for the flum throat infection)

Symptoms:

Prickling sensation in sternum area when I cough; dry cough.
yellowish/Green mostly flum.
Feverish feeling at night after the the Dolo (paracetamol medicine had elapsed its duration)

I had gone for a Complete Blood Panel Report today as well as viral, and hepatitis/HiV test.

All the tests had come out "negative" with the exception of the Dengue related thing for which I have some queries. (Typhoid, Malaria etc all negative)

I had earlier got this viral infection in Sept 2016, and probably developed some anti-bodies to this strain of virus.

Today's reports were

Dengue (Rapid Check)

Dengue NS1 Antigen-- Negative
Dengue IGM -- Negative
Dengue IGG-- Positive

Do I have dengue from the above results? The doctor said I don't have it but since it's a viral infection, the flu takes time to cure by itself.


CBP

WBC Count 5.9 (Biological Reference Level --> 4-10; Units--> 10 ^3/ul)

Platelet Count 130 (Units--> 10^3/ul; Biological Reference Level--> 150-400) (He said platelets slightly on lower side as well as WBC)

Rest of the CBP is fine.

He asked me to come after 1-2 days and get another CBP done and if platelets fall further, the next course of action can be taken.
He had said I don't have dengue but platelet and WBC count drop is due to flum and flu?

Can you folks please share your review/opinions? I would be mighty thankful.

Best Regards.
doctor
Answered by Dr. AJEET SINGH (42 minutes later)
Brief Answer:
DECREASED PLATELETS IN ABSENCE OF DENGUE

Detailed Answer:
Hi....
Welcome to "Ask a Doctor"service.
I am Dr Ajeet XXXXXXX

I have gone through your query and here is my opinion.

You do not have dengue as the test dengue NS1 antigen is negative.

IgG denotes a past exposure (subclinical) and has no clinical relevance.
IgM denotes a recent infection and is a clinically significant entity.
It is again negative in your case.

A term "Dengue like illness" (DLI) is used for viral infection which has clinical symptoms and decreased platelet count,just like dengue but the dengue tests negative.
So decreased platelet count in your case is also due to the viral infection.

A bacterial infection usually presents as increased WBC in blood work and a viral infection usually presents as decreased WBC.

All your clinical presentations are getting explained by a viral flu (also called common cold) and would subside once you recover.

You only need a supervision in the form of repeated CBC.

Hope that I have answered your query.
Stay healthy and stay blessed.
Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
DECREASED PLATELETS IN ABSENCE OF DENGUE

Detailed Answer:
Hi....
Welcome to "Ask a Doctor"service.
I am Dr Ajeet XXXXXXX

I have gone through your query and here is my opinion.

You do not have dengue as the test dengue NS1 antigen is negative.

IgG denotes a past exposure (subclinical) and has no clinical relevance.
IgM denotes a recent infection and is a clinically significant entity.
It is again negative in your case.

A term "Dengue like illness" (DLI) is used for viral infection which has clinical symptoms and decreased platelet count,just like dengue but the dengue tests negative.
So decreased platelet count in your case is also due to the viral infection.

A bacterial infection usually presents as increased WBC in blood work and a viral infection usually presents as decreased WBC.

All your clinical presentations are getting explained by a viral flu (also called common cold) and would subside once you recover.

You only need a supervision in the form of repeated CBC.

Hope that I have answered your query.
Stay healthy and stay blessed.
Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. AJEET SINGH (14 hours later)
Okay, Thanks sir.

So, what should be the follow-up course of action? In case of a viral flu, can the Platelet count drop below 75k in my case in further days? (critical limit? What Should I do?)

Since it's a viral flu as per reports (not Dengue) in how many days it might subside? Also, any particular tests (like BirdFlu, Chickengunya etc) which might need to be taken in order to confirm the presence or absence of an infection?

I got infected with Dengue in 2016 Oct-- do the antibodies that have cured viral infection that time still remain in the bloodstream?

Any further advice/suggestion doctor?

Regards,
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Follow up: Dr. AJEET SINGH (0 minute later)
Okay, Thanks sir.

So, what should be the follow-up course of action? In case of a viral flu, can the Platelet count drop below 75k in my case in further days? (critical limit? What Should I do?)

Since it's a viral flu as per reports (not Dengue) in how many days it might subside? Also, any particular tests (like BirdFlu, Chickengunya etc) which might need to be taken in order to confirm the presence or absence of an infection?

I got infected with Dengue in 2016 Oct-- do the antibodies that have cured viral infection that time still remain in the bloodstream?

Any further advice/suggestion doctor?

Regards,
doctor
Answered by Dr. AJEET SINGH (4 hours later)
Brief Answer:
DECREASED PLATELETS IN ABSENCE OF DENGUE

Detailed Answer:
Welcome back.....

The platelet count might fall further till the virus is active in the body.

There is no standard cut off for minimum platelets count but a value less than 10k is alarming and needs close medical supervision(as there is risk of bleeding).

To increase platelet count......

1.You should increase your intake of spinach,asparagus,green leafy vegetables,pomegranate,lentils,eggs,lean meat,citrous fruits,kiwi and wheat grass in your diet.
2.Take folic acid,vitamin B12 and O mega 3 supplements.
3.Keep yourself well hydrated.
4.Have probiotics.
5.There is commercially available preparations of Carica Papaya leaf extract which have a proven role to increase platelet count.

Once the body starts recovering and viral load in the body starts declining,platelet count would increase by itself.

There is no specific treatments available for dengue and viral diseases like chickengunya.
Only Supportive and symptomatics are dispensed till the body recovers by means of it's own immunity.
In my opinion,there is no point in testing the viruses at this point of time.

An antibiotic course is given to prevent any supper added bacterial infection when patient of dengue/viral illnesses are managed.
They have no role in their treatment.

Avoid heavy meals,take rest,have plentiful oral fluids and water and take only Paracetamol (and not any other NSAIDs) for fever.
Continue the medicines you have been taking for seizure disorder and insomnia.
Platelet count should be procured on every alternate day.
Do not overthink and don't be stressed.

Hope that I have answered your query.
Stay healthy and stay blessed.
Regards.




Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
DECREASED PLATELETS IN ABSENCE OF DENGUE

Detailed Answer:
Welcome back.....

The platelet count might fall further till the virus is active in the body.

There is no standard cut off for minimum platelets count but a value less than 10k is alarming and needs close medical supervision(as there is risk of bleeding).

To increase platelet count......

1.You should increase your intake of spinach,asparagus,green leafy vegetables,pomegranate,lentils,eggs,lean meat,citrous fruits,kiwi and wheat grass in your diet.
2.Take folic acid,vitamin B12 and O mega 3 supplements.
3.Keep yourself well hydrated.
4.Have probiotics.
5.There is commercially available preparations of Carica Papaya leaf extract which have a proven role to increase platelet count.

Once the body starts recovering and viral load in the body starts declining,platelet count would increase by itself.

There is no specific treatments available for dengue and viral diseases like chickengunya.
Only Supportive and symptomatics are dispensed till the body recovers by means of it's own immunity.
In my opinion,there is no point in testing the viruses at this point of time.

An antibiotic course is given to prevent any supper added bacterial infection when patient of dengue/viral illnesses are managed.
They have no role in their treatment.

Avoid heavy meals,take rest,have plentiful oral fluids and water and take only Paracetamol (and not any other NSAIDs) for fever.
Continue the medicines you have been taking for seizure disorder and insomnia.
Platelet count should be procured on every alternate day.
Do not overthink and don't be stressed.

Hope that I have answered your query.
Stay healthy and stay blessed.
Regards.




Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. AJEET SINGH (40 hours later)
Thanks sir,

As a precautionary measure, I had undergone some tests.

C-Reactive Test-->7.0 Biological Reference (BR) Level --> less than 10mg/LZ

ELISA Test/Method (Enzyme Linked Immunosorbent Assay)

Anti-Dengue (IgG Method)-- Negative (1.31) BR Level-- N/A

Anti-Dengue (IgM Method)-- Negative (0.78) BR Level-- N/A

Dengue NS1 Antigen Test-- Negative (0.14) BR Level -- NA

IgG-- <1.8= Absence of Dengue Antibodies and have not yet reached detectable levels

Equivocal= 1.8-2.2 -- too low levels of anti-bodies; repeat test after 5-10 days

Positive after >2.2 index

Dengue IgM

Positive > 1.1 index


Complete Blood Picture (CBP)

MCV (80.7) (Derived from RBC) Biological Reference Level-- 83.0- 101.0 fl

RDW-- 14.1 BRL-- 11.6-14.0%

WBC Count-- 4900 BRL-- 4000-10000 Cells/cumm

Neutrophils-- 36%

Lymphyocytes -- 49%

Absolute Neutrophil Count-- 1764 Cells/cumm

Platelet Count-- 120000 (BRL- 150000-410000/ cumm)


Glycosylated Haemoglobin-- 5.7 (Last three months sugar level)

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Follow up: Dr. AJEET SINGH (0 minute later)
Thanks sir,

As a precautionary measure, I had undergone some tests.

C-Reactive Test-->7.0 Biological Reference (BR) Level --> less than 10mg/LZ

ELISA Test/Method (Enzyme Linked Immunosorbent Assay)

Anti-Dengue (IgG Method)-- Negative (1.31) BR Level-- N/A

Anti-Dengue (IgM Method)-- Negative (0.78) BR Level-- N/A

Dengue NS1 Antigen Test-- Negative (0.14) BR Level -- NA

IgG-- <1.8= Absence of Dengue Antibodies and have not yet reached detectable levels

Equivocal= 1.8-2.2 -- too low levels of anti-bodies; repeat test after 5-10 days

Positive after >2.2 index

Dengue IgM

Positive > 1.1 index


Complete Blood Picture (CBP)

MCV (80.7) (Derived from RBC) Biological Reference Level-- 83.0- 101.0 fl

RDW-- 14.1 BRL-- 11.6-14.0%

WBC Count-- 4900 BRL-- 4000-10000 Cells/cumm

Neutrophils-- 36%

Lymphyocytes -- 49%

Absolute Neutrophil Count-- 1764 Cells/cumm

Platelet Count-- 120000 (BRL- 150000-410000/ cumm)


Glycosylated Haemoglobin-- 5.7 (Last three months sugar level)

doctor
Answered by Dr. AJEET SINGH (6 hours later)
Brief Answer:
DECREASED PLATELETS IN ABSENCE OF DENGUE

Detailed Answer:
Hi....
Thanks for getting back to me.

Your reports are normal (except platelet count,which is near normal) and almost identical to the last ones.
You are doing fine and just take care of your general health.

Best regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
DECREASED PLATELETS IN ABSENCE OF DENGUE

Detailed Answer:
Hi....
Thanks for getting back to me.

Your reports are normal (except platelet count,which is near normal) and almost identical to the last ones.
You are doing fine and just take care of your general health.

Best regards.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
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Dr. AJEET SINGH

General & Family Physician

Practicing since :1994

Answered : 2151 Questions

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Hello Doctors, I Was Recently Exposed To Winter Weather, And

Hello Doctors, I was recently exposed to winter weather, and also had some "oily food" outside the premises of my home. I was having fever from the past 5-6 days and I was taking the following medication: (1) Encorate Chrono 500 mg (Sodium Valporate; twice a day, seizure disorder as prescribed by a Neurologist) (2) Zolsoma 5mg (3-4 tablets a day as earlier I had worked in US shifts, as prescribed by a Psychiatrist) (3) Multi- Vitamin tablet ( Zincovit) (4) Dolo 650 (Paracetamol -- twice during day, at night my fever becomes 100-101, but not much chills or rashes etc (5) Azithromycin Antibotic. 500 mg once per day. (for the flum throat infection) Symptoms: Prickling sensation in sternum area when I cough; dry cough. yellowish/Green mostly flum. Feverish feeling at night after the the Dolo (paracetamol medicine had elapsed its duration) I had gone for a Complete Blood Panel Report today as well as viral, and hepatitis/HiV test. All the tests had come out "negative" with the exception of the Dengue related thing for which I have some queries. (Typhoid, Malaria etc all negative) I had earlier got this viral infection in Sept 2016, and probably developed some anti-bodies to this strain of virus. Today's reports were Dengue (Rapid Check) Dengue NS1 Antigen-- Negative Dengue IGM -- Negative Dengue IGG-- Positive Do I have dengue from the above results? The doctor said I don't have it but since it's a viral infection, the flu takes time to cure by itself. CBP WBC Count 5.9 (Biological Reference Level --> 4-10; Units--> 10 ^3/ul) Platelet Count 130 (Units--> 10^3/ul; Biological Reference Level--> 150-400) (He said platelets slightly on lower side as well as WBC) Rest of the CBP is fine. He asked me to come after 1-2 days and get another CBP done and if platelets fall further, the next course of action can be taken. He had said I don't have dengue but platelet and WBC count drop is due to flum and flu? Can you folks please share your review/opinions? I would be mighty thankful. Best Regards.