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Year : 2020  |  Volume : 9  |  Issue : 7  |  Page : 3737-3740

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

1 Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2 Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Correspondence Address:
Dr. Prasan Kumar Panda
Department of Medicine, Fifth Floor, College Block, All India Institute of Medical Sciences (AIIMS), Rishikesh - 249203, India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jfmpc.jfmpc_711_20

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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.

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