Reevaluating Dengue Management: Insights Into Fever Trends, Thrombocytopenia, and Clinical Outcomes.

Introduction  Dengue fever remains a major public health challenge in endemic regions, leading to significant hospital admissions and resource utilization. This study aimed to analyze the clinical course of dengue, focusing on fever trends, thrombocytopenia, hematocrit fluctuations, and bleeding manifestations. Methods A retrospective observational study was conducted on 135 confirmed dengue patients admitted to Alkhidmat Raazi Hospital, a secondary care hospital in Rawalpindi, which is a dengue-endemic region. Clinical and laboratory data, including fever patterns, platelet counts, hematocrit levels, and total leukocyte count trends, were recorded over the course of the illness. Patient outcomes and symptomatology were analyzed to determine the necessity of hospitalization. Results Among 135 patients, 118 (87.4%) had uncomplicated dengue fever, while 12 (8.9%) developed dengue hemorrhagic fever. Despite all patients experiencing thrombocytopenia at some stage, 19 (14.1%) had platelet counts below 20,000/µL without any bleeding. Fever trends followed a biphasic pattern, with resolution observed in 101 (74.5%) patients by day 10. A total of 38 (28.1%) patients remained afebrile for over 72 hours despite a declining platelet count, indicating fever resolution independent of thrombocytopenia. The median length of hospital stay was three days (range: 1-10 days), with 107 (79.3%) patients having no comorbidities. Bleeding manifestations were seen in 22 (16.3%) patients, with nasal bleeding in eight (36.3%) and gum bleeding in six (27.2%) patients. Conclusion This study reinforces the idea that hospital admissions for dengue should not be based solely on platelet counts. Structured outpatient monitoring could help reduce unnecessary admissions, optimizing healthcare resources. Future studies should explore home-based care models to improve dengue management.