Differential Diagnosis for Fever with Leukopenia and Thrombocytopenia
- Single Most Likely Diagnosis
- Viral Hemorrhagic Fever (e.g., Ebola, Lassa Fever, Dengue): These infections are known to cause severe bone marrow suppression, leading to leukopenia and thrombocytopenia, along with high fever. The severity and combination of these symptoms make viral hemorrhagic fevers a top consideration.
- Other Likely Diagnoses
- Malaria: Certain types of malaria, particularly falciparum malaria, can cause bone marrow suppression, resulting in leukopenia and thrombocytopenia. The presence of fever is a hallmark of malaria.
- Typhoid Fever: Caused by Salmonella Typhi, this condition can lead to bone marrow suppression and subsequently to leukopenia and thrombocytopenia, especially in severe or untreated cases.
- Ehrlichiosis/Anaplasmosis: These tick-borne illnesses can cause fever, leukopenia, and thrombocytopenia due to the infection of bone marrow cells.
- Do Not Miss Diagnoses
- Septicemia: Although sepsis more commonly causes leukocytosis, certain cases, especially those involving gram-negative bacteria or severe sepsis, can lead to leukopenia. The combination of fever, leukopenia, and thrombocytopenia in sepsis is critical and potentially life-threatening.
- Disseminated Intravascular Coagulation (DIC): This condition can arise from various causes, including severe infections, and is characterized by both thrombocytopenia and a coagulopathy, which can be life-threatening if not promptly addressed.
- Rare Diagnoses
- Aplastic Anemia: A rare condition characterized by bone marrow failure, which can present with fever, leukopenia, and thrombocytopenia. It is less likely than infectious causes but should be considered in the appropriate clinical context.
- Hantavirus Infection: Certain strains of hantavirus can cause hantavirus pulmonary syndrome (HPS) or hemorrhagic fever with renal syndrome (HFRS), both of which can present with fever, thrombocytopenia, and leukopenia, although these are less common presentations.
- Relapsing Fever (Borrelia): Caused by Borrelia species transmitted by ticks or lice, this infection can lead to recurring episodes of fever, and in some cases, may cause leukopenia and thrombocytopenia, especially during the febrile episodes.