thanks everyone!
unfortunately, there's no cure for this. one can only make sure that the patient does not dehydrate (IV) and being sure to be ready with a blood transfusion once bleeding or platelet counts become too low.
a normal person's platelet count should be around 150-400 whatever units.
she had 158 last thursday
102 last friday AM
60 friday night
40 saturday AM
20 is the cutoff for transfusion.
good news is i think the fever is breaking.
That is going to leave you with a bit of a cliff hanger. As long as she does not go into shock the platelet count will rebound pretty soon. She is at the critical phase now. Shock, if it occurs, comes when the temperature settles.
In the unlikely event shock ensues, she will of course require expert critical care. Of course the physicians in Manila, unlike parochial physicians like me, will have experience of this clinical situation.
I certainly concur with platelet support below 20,000. Platelets are the cells that stop us bleeding and plug holes in blood vessels. You have left three zeros off your numbers by the way. The platelets are disappearing by attaching themselves to the small blood vessels, the capillaries. This is a form of consumptive coagulopathy. This process does damage to the capillaries, and can allow fluid to pass in large quantities into the tissues. This is the cause of the shock in those cases that develop it. It requires aggressive fluid support. This process occurs as a consequence of a great many severe illnesses, and is one of the commonest situations that critical care physicians confront in clinical practice.
I wish you both strength and fortitude during this anxious time, and pray the crisis will be over soon.
