Thrombocytopaenia as defined by platelet counts under 150,000/μL seems to be very frequent among patients with vivax malaria and apparently more frequent in vivax than in falciparum patients [104] , despite not being a consensus [105] . The increase in the report of thrombocytopaenia in several reference centres could also be a reflection of a better laboratorial infrastructure. Only in recent decades in developing countries automated full blood counts included platelet count as a routine. Many studies in Brazil confirm that platelet counts are directly correlated to peripheral parasitaemia [89, 90] , but the meaning of this finding is still unknown. However, only mild bleeding is usually associated with this haematological complication in studies where detailed and systematic clinical description of the patients was made, even for severe thrombocytopaenia, which means in general platelet count under 50,000/μL [81, 89, 90] . In fact, there is no report in the whole literature of a fatal case of patient presenting exclusively with severe thrombocytopaenia, even for P. falciparum. That is probably why thrombocytopaenia, regardless of being described as a complication by WHO, is not strictly-speaking considered a severity criterion by itself [106] . What happens most of the time is that thrombocytopaenia is usually taken as a surrogate marker for DIC in settings where no specific examinations to confirm this severe complication are available, such as prothrombin activation time, D-dimers and fibrin degradation products. However, there is a disproportionate difference in the proportions of thrombocytopaenia, which is considered relatively frequent in large studies for frequency estimation [90] and of DIC, which is a rare complication, very scarcely reported in the literature associated to P. vivax infection [107, 108] . Actually, there is some coagulation cascade activation, but usually with minor impact on coagulation tests and platelet counts [83] . It is important to consider however that in areas where dengue is also endemic, as is the case of Brazil, thrombocytopaenia studies should obligatorily rule out this viral infection, which also presents a substantial percentage of thrombocytopaenia as part of its non-severe presentation [109] . In fact there are cases of co-infection already reported in the Brazilian Amazon recently [110] , but the literature poorly describes the clinical aspects of this coincidental infection [111] .