Thrombocytopenia is commonly seen in severe falciparum malaria. It is presumed to be due to increased consumption of the platelets in the periphery, may be in the spleen.
Bone marrow shows appropriate megakaryocyte response.
However, bleeding due to thrombocytopenia is very rare in malaria. Corticosteroids are not indicated. However, if thrombocytopenia is severe, platelet transfusion may be considered. Generally, the platelet count returns to normal with the completion of antimalarial chemotherapy. It tends to be more common in patients with cerebral malaria, pregnancy and secondary bacterial infections.