In addition, anemia and a decrease in erythrocytes, platelets, and hemoglobin occurs. Visible hemorrhagic spots begin to appear on the skin. This stage last for 3-4 weeks. The transition to the third stage is sudden, and symptoms progress rapidly. During the hemorrhagic stage, petechial hemorrhages occur on the skin of the trunk, arms, thighs, face, and head.
Capillaries are fragile, and any slight trauma results in hemorrhage.
Hemorrhages of the mucous membranes of the mouth, tongue, soft palate, and tonsils occurs. Nasal, gastric, and intestinal hemorrhages can be severe. Areas of necrosis begin to appear on the lips, fingers, nose, jaws, eyes, and in the mouth. Death may occur from hemorrhages, strangulation due to swelling, or secondary infections. Fifty percent of those who enter this stage will die.