Hello. Thanks for writing to HCM. Petechiae especially extensive ones like you describe, indicate some dysfunction of the platelets. Platelets in the blood help in stopping bleeding, alongwith other factors. Your rectal bleeding may directly be a result of this while your cough may or may not indicate bleeding into the lungs. A complete blood count will demonstrate your platelet count as well as the WBC count. If you are not experiencing fever or swelling of the glands, it is unlikely that you have any infection like dengue which causes drop in platelets. We then have to think of other causes - most of which are liver disorders or spleen disorders. Liver disorders like cirrhosis of the liver due to any cause, decrease the platelets. Confirmation will be by a liver function tests and an ultrasound of the liver. Spleen disorders like ITP may sometimes cause such extensive bleeding manifestations, even though generally they just cause asymptomatic drop in the platelet count. Confirmation is by exclusion of other causes. An abdominal ultrasound may show an enlarged spleen. You need early investigation for this as it indeed may cause serious bleeding if left untreated. Wishing you a speedy recovery. Regards, Dr Geeta