Thrombocytopenia is very common presentation of acute febrile illness. Mostly they are viral in etiol. like dengue fever. The white blood cells respond by producing a number of signaling proteins, such as cytokines and interferon's, which are responsible for many of the symptoms, such as the fever, the flu-like symptoms and the severe pains. In severe infection, the virus production inside the body is greatly increased, and many more organs (such as the liver and the bone marrow) can be affected. Fluid from the bloodstream leaks through the wall of small blood vessels into body cavities due to capillary permeability. As a result, less blood circulates in the blood vessels, and the blood pressure becomes so low that it cannot supply sufficient blood to vital organs. Furthermore, dysfunction of the bone marrow due to infection of the stromal cells and peripheral destruction of platelets in spleen leads to reduced numbers of platelets, which are necessary for effective blood clotting; this increases the risk of bleeding, the other major complication of dengue fever. The use of low dose corticosteroids helps in stopping the ongoing immune destruction of platelets and hence avoiding platelet transfusion and its associated complications and overall its cost effectiveness in the management of viral thrombocytopenia in Indian scenario.