Thrombocytopenia is a common manifestation of all tick-borne diseases. Low platelet numbers contribute significantly towards the morbidity and mortality of infection. However, the pathogenesis of thrombocytopenia in many of the tick-borne diseases is poorly understood. Quantitative changes in platelet counts associated with infection may result from decreased marrow production, hypersplenism, consumption due to widespread endothelial damage or disseminated intravascular coagulation, as well as immune-mediated platelet destruction. Infection-induced thrombocytopenia may infrequently be associated with serious thrombosis. Direct infection of platelets by selected tick-borne pathogens also facilitates their dissemination within the host. This article reviews the mechanisms of thrombocytopenia associated with tick-borne infections, and discusses the therapeutic options available for managing this potentially fatal complication.
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