Most clinicians are willing to accept granulocytopenia as both a sign and a complication of gram-negative bacteremia, but are not accustomed to regarding thrombocytopenia in the same way.1 Six cases in which thrombocytopenia was a prominent feature in association with gramnegative sepsis are described in a recent issue of the Archives of Internal Medicine.2 One of the cases had a short survival of labeled platelets with radioactive chromium (51Cr), suggesting peripheral platelet destruction as the mechanism for the thrombocytopenia, a finding in keeping with the evidence that endotoxin causes morphologic changes, platelet aggregation, and release of thromboplastic phosphatides (platelet factor III) in vitro. Using this as a basis for a retrospective study, the investigators also found that in cases with gram-negative bacteremia, random platelet counts were below normal in at least nine other cases in their hospital over a one-year period.
The importance of this description is
THROMBOCYTOPENIA IN GRAM-NEGATIVE BACTEREMIA. JAMA. 1966;195(8):680-681. doi:10.1001/jama.1966.03100080120038