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Thrombocytosis after pneumonia with empyema and other bacterial infections in children
1Department of Pediatrics, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.
Insights
Severe bacterial infections in children, especially pneumonia with empyema, frequently cause thrombocytosis (elevated platelet counts). Platelet levels normalized within three weeks without observed complications.
Area of Science:
- Pediatric Infectious Diseases
- Hematology
- Critical Care Medicine
Background:
- Thrombocytosis, an elevated platelet count, is a known complication of various conditions, including infections.
- The specific phenomenon of thrombocytosis following severe pediatric bacterial infections requires further investigation.
Purpose of the Study:
- To investigate the incidence and characteristics of thrombocytosis in children with severe bacterial infections, particularly pneumonia with empyema.
- To compare thrombocytosis occurrence in pneumonia with empyema to other pediatric infections like lobar pneumonia, meningitis, and osteomyelitis.
Main Methods:
- A systematic survey was conducted on 27 children admitted for pneumonia with empyema.
- Platelet counts were monitored, and platelet function tests were performed on a subset of patients.
- Bone marrow aspiration was performed on three patients.
Main Results:
- Thrombocytosis was observed in 92.5% of children with pneumonia and empyema.
- Platelet counts peaked around 15 days and normalized within 3 weeks.
- Significant thrombocytosis was also noted in children with lobar pneumonia, meningitis, and osteomyelitis, though less frequently.
- No platelet function abnormalities, thromboembolic, or hemorrhagic events were observed.
Conclusions:
- Thrombocytosis is a common reactive finding in children with severe bacterial infections, especially pneumonia with empyema.
- The observed thrombocytosis appears to be a reactive process without functional impairment or associated complications.
- Megakaryocytic hyperplasia in bone marrow supports a reactive thrombopoiesis mechanism.
Abstract:
Thrombocytosis is seen in association with many conditions, including infectious diseases. We studied thrombocytosis after severe bacterial infections, particularly pneumonia with empyema in children. A systematic survey of the phenomenon was conducted. Twenty-seven children admitted for pneumonia with empyema were studied. Thrombocytosis (platelet counts greater than 500 x 10(3)/microliters) was present in 92.5%. Platelet counts reached their maximum at 15.1 +/- 3.7 days (range, 7 to 25) and declined to normal after 3 weeks of illness. Compared with a healthy control group, significant thrombocytosis, but of lower incidence, was also noted in children with lobar pneumonia without pleural effusion, bacterial meningitis and osteomyelitis. Platelet functions were examined in seven of the children but no abnormalities were observed. Bone marrow aspiration of three children with pneumonia and empyema showed megakaryocytic hyperplasia. We found no correlation between thrombocytosis, neutrophilia, fever, the clinical course, complications, prognosis or treatment. Neither thromboembolic nor hemorrhagic phenomena were observed.