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Sepsis-associated thrombocytopenia — RACP Paediatrics MCQ

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ModerateNeonatalSepsis-associated thrombocytopeniaRACP Paediatrics

A preterm infant (30 weeks) on day 3 develops thrombocytopenia (platelets 40), fever, and clinical deterioration with metabolic acidosis. CRP is markedly elevated. Blood cultures are positive for coagulase-negative staphylococcus. What is the most likely cause of the thrombocytopenia?

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Correct answer: D — Sepsis

Late-onset sepsis is the most common cause of thrombocytopenia in premature neonates. Thrombocytopenia in the setting of clinical sepsis (fever, metabolic acidosis, elevated CRP, positive blood cultures) is typically consumptive. It usually resolves with successful treatment of the underlying infection.

Reference: RCH Melbourne – 2023 – Neonatal Sepsis CPG; RACP Paediatric Curriculum – Neonatology