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Case Reports
. 2020 Jul 30;9(7):3737-3740.
doi: 10.4103/jfmpc.jfmpc_711_20. eCollection 2020 Jul.

Influenza B presenting with bicytopenia in an adult - An unusual presentation and failure of antimicrobial stewardship by a practicing physician

Rajat Ranka  1 , Deepjyoti Kalita  2 , Prasan Kumar Panda  1
Affiliations
Case Reports

Influenza B presenting with bicytopenia in an adult - An unusual presentation and failure of antimicrobial stewardship by a practicing physician

Rajat Ranka et al. J Family Med Prim Care. .

Abstract

Influenza is a very common cause of upper respiratory illness, rarely presented with bicytopenia, and is being wrongly treated with antimicrobials many-a-times. We report a case of 36-year-old North-Indian man, physician by profession who presented with a 5-day history of typical upper respiratory tract symptoms (sore throat, irritative cough, hoarseness of voice, coryza) and high-grade fever for which he took antibiotics (initially levofloxacin for 2-days, followed by azithromycin) after self-prescription. He developed hematological involvement (leukopenia and thrombocytopenia) for which he was admitted. Throat swab tested positive for Influenza B by RT-PCR. This case highlights a rare presentation of influenza as bicytopenia which rapidly improved with oseltamivir given for 5-days. This is also a classic case of lack of antimicrobial stewardship practice by a physician while self-treating viral pharyngitis. There is a pressing need to create more awareness regarding appropriate use of antimicrobial resources among doctors, only then will others follow.

Keywords: Antimicrobial stewardship; flu; leukopenia; oseltamivir; thrombocytopenia; viral fever.

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Conflict of interest statement

There are no conflicts of interest.

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