Pseudothrombocytosis in a patient with severe burn injuries: A case report highlighting the pitfalls of automated platelet counting

We report a case of pseudothrombocytosis in a 39-year-old male with severe burn injuries involving 45% of the total body surface area. Initial automated hematology analyzer results indicated extreme thrombocytosis (1630 × 10 3 /μL); however, manual smear review and platelet (PLT) counts revealed true thrombocytopenia. Peripheral smear examination showed abundant red blood cell (RBC) fragments and spherocyte aggregates, which were misclassified as PLTs by an impedance-based analyzer. This case highlights the limitations of automated PLT counting in the context of burn-induced hemolysis and underscores the need for manual verification to prevent diagnostic errors. We propose a diagnostic algorithm that integrates smear morphology thresholds to enhance the recognition of pseudothrombocytosis in cases of thermal injury.