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Original Articles
Significance of Thrombocytosis in Children with Severe Bacterial Infection
Seung Beum Cho, Heung Sik Kim, Chin Moo Kang
Department ofPediatrics, Keimyung University, School of Medicine, Taegu, Korea
Vol.26 Num.2 (p145~154)
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), sepsis(10 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 studies as control.
The following results were obtained.
Out of 72 children with severe bacterial infections, 59 cases(81.94%) had maximal platelet count above 450×103/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 600×103/μL, were 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±183.37×103/μL in severe infections and 336.53±80.72×103/μL in control group.
The mean value was highest in acute osteomyelitis(759.7±147.44×103/μL) followed by empyema(691.9±152.04×103/μL), meningitis(599.7±203.65×103/μL), pneumonia(527.9±145.26×103/μL) and sepsis(503.3±144.84×103/μL) in order. Remarkable statistical significance in degree of thrombocytosis was noted 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 in empyema) and declined to normal value between second and fourth week(14.81±4.70 days in sepsis~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 ESR(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.
Keywords : Severe bacterial infection, Thrombocytosis