Neonatal Scabies Associated with Severe Thrombocytopenia: A Case Report and Literature Review
Livio Antonazzo, MD1*, Giovanni Liguori, MD2, Anna Rita Fusco, MD3, Teresa Delnegro, Nurse1, Samuela Daniela Cannale, Nurse1, Giuseppe Pisu, Nurse1, Ornella Li Moli, MD1
1Pediatric Emergency Department, Giovanni XXIII, University Children's Hospital, Bari, Italy.
2Dermatology Department, Policlinico di Bari University Hospital, Bari, Italy.
3Immuno-tranfusional Service, Hygiene and Public Health Department - San Paolo Hospital Bari, Italy.
*Corresponding Author: Livio Antonazzo, MD, Pediatric Emergency Department, Giovanni XXIII - Policlinico Bari, University Hospital, Italy.
https://doi.org/10.58624/SVOAPD.2026.05.030
Received: August 29, 2026
Published: September 18, 2026
Citation: Antonazzo L, Liguori G, Fusco AR, Delnegro T, Cannale S.D, Pisu G, Li Moli O. Neonatal Scabies Associated with Severe Thrombocytopenia: A Case Report and Literature Review. SVOA Paediatrics 2026, 5:5, 197-202. doi: 10.58624/SVOAPD.2026.05.030
Abstract
Background: Scabies is a common parasitic skin infestation in children but is rarely reported during the neonatal period. Its clinical presentation in neonates may be atypical, potentially delaying diagnosis. Hematological abnormalities are not generally considered part of the routine diagnostic assessment of scabies.
Case presentation: A 22-day-old term female neonate was admitted to the Pediatric Emergency Department because of a widespread skin rash that had been present for approximately one week and increasing irritability during the previous 24 hours. She was afebrile, breastfeeding normally, and showed appropriate weight gain. Physical examination revealed widespread erythematous papules, crusted and eroded lesions, and linear track-like lesions involving the hands and face. A family history of scabies was subsequently identified. Dermatological assessment supported the clinical diagnosis of scabies, although the mite was not identified. Because of the extensive and prolonged skin involvement in a neonate, laboratory investigations were performed and unexpectedly revealed severe thrombocytopenia, with a platelet count of 28,000/mm³, confirmed by the hospital central laboratory. Inflammatory markers and renal and liver function tests were unremarkable. The infant was hospitalized for treatment of scabies and hematological monitoring. Following treatment of the infestation, the skin lesions resolved and the platelet count returned to normal.
Discussion: Thrombocytopenia associated with neonatal scabies has been described in a limited number of previous reports. The recurrence of a potentially severe hematological abnormality in several independently reported cases is noteworthy, particularly given the rarity of scabies in the neonatal period. Experimental studies have also demonstrated that Sarcoptes scabiei products can modulate cytokine production and endothelial adhesion molecule expression, although a direct mechanism linking infestation to thrombocytopenia has not been established. Conclusion: Severe thrombocytopenia may represent an uncommon and clinically silent complication associated with neonatal scabies. Considering neonatal immunological immaturity, the potential severity of undetected thrombocytopenia, and the simplicity and limited invasiveness of a complete blood count, we propose that a complete blood count should be routinely performed in neonates diagnosed with scabies, even in the absence of overt systemic manifestations.
Keywords: Scabies; Sarcoptes Scabiei; Neonate; Newborn, Neonatal Scabies; Thrombocytopenia; Platelet; Eosinophilia; Hematology; Inflammation, Cytokine