Thrombocytosis in Hemorrhagic Stroke: Case Report and Literature Review

Background Thrombocytosis is a condition characterized by a platelet count higher than 450,000/μl. In instances of severe thrombocytosis, the number of platelets reaches 1,000,000 per microliter. Thrombocytosis is commonly identified as an unexpected aberration in laboratory tests, as the majority of patients do not show any symptoms. Thrombocytosis can be categorized into two types: essential thrombocytosis (primary) and reactive thrombocytosis (secondary). Reactive thrombocytosis is the predominant form of thrombocytosis. Within the population of persons with thrombocytosis, around 80% to 90% are specifically identified as having reactive thrombocytosis. Case Presentation This is a case report of a 73-year-old man who arrived at the emergency room with symptoms, including loss of consciousness, weakness on the right side of his body, high blood pressure, and difficulty breathing. Further investigations have revealed the patient to have a high platelet count (1,186,000/µL), a hemorrhagic stroke, and pneumonia. Discussion This case report describes the presence of thrombocytosis in a patient who has experienced a hemorrhagic stroke. The patient displayed a condition of extreme thrombocytosis, marked by a platelet count exceeding 1,000,000 per microliter (µL). The brain CT scan showed a 42 cc intracerebral haemorrhage in the right temporal lobe, resulting in impending obstructive hydrocephalus. The patient also reported experiencing dyspnoea and fever one week prior to hospitalisation, and his sputum culture revealed the presence of Klebsiella pneumoniae bacteria. Conclusion This case report demonstrates the clinical presentation of a hemorrhagic stroke accompanied by reactive thrombocytosis, with pneumonia being the major infection linked with reactive thrombocytosis.