Author: Ravi Tota Maharaj / Editor: Sarah Edwards / Codes: DC8, DP1, DP2, HC4, HP1, HP3, SLO3, SLO5 / Published: 18/12/2024
A 5-year-old girl is brought to the Emergency Department (ED) by her parents due to widespread bruising and bleeding symptoms. She had been exposed to chickenpox at school two weeks prior and developed an itchy rash consistent with varicella infection a few days ago. Over the past two days, her parents noticed worsening ecchymoses on her skin, petechiae. It was also reported that she had three episodes haematuria and one episode of epistaxis. She has no history of fever, vomiting, or abdominal pain.
Her examination revealed an alert, playful, and afebrile patient, with normal vital signs. She was noted to have multiple petechiae and bruises on her skin and oral mucosa. There was no obvious lymphadenopathy or hepatosplenomegaly. Cardiovascular and respiratory examinations are unremarkable.
Laboratory investigations are ordered, including a full blood count, coagulation profile, and renal and liver function tests. Results reveal a critically low platelet count of 2 × 10⁹/L, with normal haemoglobin and white blood cell counts, indicating severe isolated thrombocytopenia.
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