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[Diagnostic difficulties of transfusion incidents due to bacterial contamination: report of two cases]
Abstract:
The French hemovigilance system has recently underlined the relative frequency of transfusion-associated bacterial sepsis and the necessity to remain constantly aware of this eventuality. We describe the experience of a hematology unit over a 18-month period: 189 acute transfusion reactions were registered and bacterial cultures of the implicated cellular blood products realized in 82 of them. A positive result was obtained in two cases. For both cases, clinical symptoms of transfusion reaction were limited to a lasting fever, and a skin rash occurred in aplastic patients with preexisting signs of sepsis. The causal relationship between this contamination and the transfusion reaction is difficult to establish. Clinical manifestations justifying a bacterial inquiry must therefore be more precisely defined, particularly in multitransfused patients.
Insights
Transfusion-associated bacterial sepsis is a rare but serious risk. Careful monitoring for specific symptoms like fever and rash in high-risk patients is crucial for early detection and management.
Area of Science:
- Hematology
- Infectious Disease
- Patient Safety
Background:
- The French hemovigilance system highlights the frequency of transfusion-associated bacterial sepsis.
- Constant vigilance for this adverse event is necessary in clinical practice.
Observation:
- An 18-month study in a hematology unit registered 189 acute transfusion reactions.
- Bacterial cultures were performed on implicated blood products in 82 cases.
- Positive bacterial cultures were identified in two cases.
Findings:
- In both positive cases, symptoms included persistent fever and skin rash.
- Affected patients had aplastic conditions and pre-existing sepsis signs.
- Establishing a direct causal link between contamination and reaction was challenging.
Implications:
- Precise clinical criteria are needed to justify bacterial investigation of transfusion reactions.
- Particular attention is required for multitransfused patients.
- This study emphasizes the importance of robust hemovigilance protocols.
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