In this issue there is a report (page 577) of a patient in whom intracranial hemorrhage occurred as a consequence of thrombocytopenia complicating chickenpox. This serious but, fortunately, uncommon result of infection-related bleeding disorders in children brings into focus the need for proper diagnosis and the problems of management of these situations.
The authors have stressed the need to distinguish between simple thrombocytopenia and disseminated intravascular coagulation (DIC) when bleeding occurs in relation to an infectious disease such as chickenpox. In the former condition, only thrombocytopenia will be found with no anemia unless significant blood loss has occurred. Measurements of plasma clotting factors will all have normal values. The bone marrow sample will have normal-to-increased numbers of megakaryocytes in response to the rapid platelet destruction.
The results of studies of a patient with DIC may be variable. Thrombocytopenia is usual, and also present may be anemia associated with blood-smear