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Give me the diagnosis according to the report
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"dengue"[MeSH Terms] AND "leukopenia"
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The reports don't state a diagnosis. Taken together, the pattern points to an acute viral febrile illness, most likely dengue. This is an inference from the labs alone. I don't have her symptoms, fever history or examination findings. I also read the values directly from the photos. I tried to run the image-analysis tool, but it failed because I passed it a wrong URL.
Abnormal findings (Vidhi Patle, 18 F, 04/11/2026)
| Test | Result | Reference |
|---|---|---|
| WBC | 2.2 (low) | 4-10 |
| Lymphocytes | 0.3 absolute, 14.7% (low) | 0.8-4.0, 20-40% |
| Granulocytes | 1.8 absolute (low), 81.5% (high) | 2.0-7.0, 50-70% |
| Platelets | 82 (low) | 100-300 |
| Hb | 11.8 | 11-15 (normal) |
| Hct | 36.9 (slightly low) | 37-47 |
| MCV | 102.9 (slightly high) | 80-100 |
| MPV | 12.4 (high) | 6.5-12 |
| SGPT (ALT) | 189 | 7-56 |
| SGOT (AST) | 172 | 10-40 |
| Na | 133 (low) | 135-145 |
| CRP | 13.7 | up to 6 |
Normal results: bilirubin, urea, creatinine, random glucose (72), K (3.5, at the lower limit), Cl, and the malaria card test (PV and PF negative).
Interpretation
- Leukopenia with thrombocytopenia is a mild bicytopenia. Hb is preserved, so this is not a full pancytopenia.
- Raised ALT and AST (about 4 times normal) with normal bilirubin points to hepatocellular injury, not cholestasis.
- Low sodium and mildly raised CRP fit a systemic infection.
- Malaria is negative on the card test. That removes one of the main causes of fever with low platelets.
For dengue, the textbooks list thrombocytopenia, leukopenia and mildly raised aminotransferases as typical laboratory findings:
- Harrison's Principles of Internal Medicine 22E, Fever and Myalgia: "leukopenia, thrombocytopenia, and, in many cases, modest elevations of serum AST activity without hepatic synthetic dysfunction."
- Goldman-Cecil Medicine, Diagnosis (dengue): thrombocytopenia, leukopenia and mildly elevated liver aminotransferases. A rising hematocrit with a rapid platelet fall after the fever settles suggests risk of severe dengue.
Other possibilities
- Enteric (typhoid) fever
- Scrub typhus
- Leptospirosis
- Chikungunya
- Acute viral hepatitis (A or E)
- Early sepsis
- Less likely: a nutritional cause (B12 or folate deficiency). Her MCV is slightly high, but her Hb is normal.
Tests to confirm
- Dengue NS1 antigen (in the first 5 days of fever) and dengue IgM/IgG
- Peripheral smear
- Typhoid culture or Widal
- Scrub typhus IgM
- Hepatitis A and E IgM
- Leptospira serology if there is exposure risk
Monitoring if dengue is suspected
- Repeat CBC every 12 to 24 hours.
- Watch for a rising hematocrit with a falling platelet count.
- Watch for warning signs: abdominal pain, persistent vomiting, bleeding, lethargy.
- Keep her well hydrated.
- Avoid NSAIDs and aspirin.
A recent PubMed check turned up no new evidence that changes this interpretation. A treating physician should confirm the diagnosis with the clinical picture and the tests above.
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