An elevated blood platelet count has been reported in a number of clinical conditions. Primary thrombocytosis associated with the myeloproliferative disorders is well known and secondary or reactive thrombocytosis has been related to several
conditions
such as malignancies, infections and postsplenectomy or other surgical conditions.
This study was carred out on 72 children with severe bacterial infections who were admitted to the department of Pediatrics, Cong San Medical Center, Keimyung University to investigate the response of thrombocytes to the severe bacterial
infections
and
to observe the changing patterns of thrombocytes in severe infections.
Pneumonia(17 cases), empyema(15 cases), meningitis(18 cases)and acute osteomyelitis(10 cases) were included for this study and 30 cases of inguinal hernia admitted for herniorrhaphy otherwise healthy were studied as control.
The following results were obtained.
Out of 72 children with severe bacterial infections, 59 cases(81.94%) had maximal platelet count above 450×10E3/μl.
Thrombocytosis were observed in 70.6% of pneumonia, 93.3% of empyema. 70.0% of sepsis 77.8% of meningitis and 100.0% of acute osteomyelitis.
Severe thrombocytosis, platelet count above 600×10E3/μl, observed in 51.4% of the children with severe infections and more frequently seen in empyema(86.7%) and acute osteomyelitis(83.3%) than in other groups.
The mean value of maximal platelet count was 615.54±183.37×10E3/μ l in severe infections and 336.53±80.72×10E3/μl in control group.
The mean value was highest in acute osteomyelitis(759.7±147.44×10E3/μl) followed by empyema(691.9±152.04×10E3/μl), meningitis(599.7±203.65×10E3/μ l), pneumonia(527.9±145.26×10E3/μl) and sepsis(505.3±144.84 ×10E3/ μl) in order.
Remarkable
statistical significance in degree of thrombocytoses was norted between severe infections and the control group(p<0.001).
Maximal platelet count usually occured between the first and second week after admission(7.11±3.95 days in meningitis∼ 10.86±6.52 days in empyema) and declined to normal value between second and fourth week(14.81± 4.70 days in
sepses∼24.27±5.58
days in acute osteomyelitis).
There was-no significant correlation between thrombocyte count and hemoglobin(r=-0.403, P>0.05), leukocyte count(r=0.400, P>0.05) and (r=0.494, P>0.05).
High incidence of secondary thrombocytosis in children with severe bacterial infection was observed in this study and the incidence and the degree of thrombocytosis in children with severe protracted pyogenic bacterial infections such as acute
osteomyelitis and empyema were significantly higher than in other groups.
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