Hello, Thrombocytopenia is defined as a platelet count below the lower limit of normal (For severe thrombocytopenia is an extremely rare complication of acute Epstein Barr Virus (EBV) infection. EBV infection usually causes hematological abnormalities, mainly atypical lymphocytosis(high lymphocyte count), which is a feature of infectious mononucleosis, and uncomplicated cases often present with mild decreases in platelet counts. Does she has acute thrombocytopenia? If her thrombocytopenia from EBV , IV steroid and oral steroid will be effective and full recovery of the platelet count. EBV infection may happen in children, adolescents and adults and this differential diagnosis should be considered in every patient presenting with acute thrombocytopenia. The prognosis for most who are infected with EBV is usually good as most people recover completely without any of complications. You should follow up with your home doctor after you take a course of steroid treatment. ITP is caused by the immune system mistakenly attacking and destroying platelets. In most children with ITP, the disorder follows a viral illness, such as the mumps or the flu. The spleen, which helps your body fight infection, recognizes the antibodies and removes the platelets from your system. The result of this case is a low number of platelets in circulation. Risk factor is your sex (women are two or three times more likely to develop ITP than men and viral infection). To make the diagnosis of ITP you should exclude other possible causes of bleeding and low platelet counts, such as an underlying illness or medications your daughter may be taking. My practice I also give steroid to the patients as the first choice of treatment. If it does not improve we will use the other medicine for suppressing your immune system. Surgery to remove spleen if her condition is severe or persists despite initial drug treatment. She should avoid activities that could cause injury, avoid alcohol, watch for sign of infection. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Heang Chan Raksmey, General & Family Physician