Severe Thrombocytopenia in Infective Endocarditis

Thrombocytopenia can be seen in about 20-25% of patients with bacterial infective endocarditis (IE). Platelets have a major role in the pathogenesis of endocarditis, and they are also sensitive monitors of systemic host response to bacteremia. Thrombocytopenia on presentation of patients with IE identifies higher risk groups and carries higher mortality risk. The presence of thrombocytopenia is an independent prognosticator of poor outcomes in IE. We present a case of a 40-year-old male with the history of injection drug use who was diagnosed with IE and was found to have severe thrombocytopenia on admission was treated with intravenous antibiotics, which dramatically improved his platelet counts as well without any need for plasmapheresis or platelet transfusions.