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Late postoperative fever--viral infection following multiple blood transfusion
Abstract:
The possibility of acquiring a viral infection by blood transfusion, although recognized for nearly 20 yr, is often ignored. Surgeons and internists submit patients to sophisticated, and sometimes invasive, diagnostic and therapeutic procedures without considering this possibility. We report here on two patients in whom febrile illness appeared about 5 wk after surgery. Both had received multiple blood transfusions in the perioperative period. Initial diagnoses indicated typhoid fever in one patient who received chloramphenicol therapy, and endocarditis in the other patient who was given massive combined antibiotic therapy. Both were later diagnosed by serologic methods as having cytomegalovirus and Epstein-Barr virus infection, respectively. Review of the literature reveals that this mechanism of acquiring these frequently asymptomatic viral infections is surprisingly common.
Insights
Blood transfusions can transmit viral infections like cytomegalovirus and Epstein-Barr virus, often overlooked in clinical practice. Prompt diagnosis and awareness are crucial for patient safety and effective treatment.
Area of Science:
- Infectious Diseases
- Transfusion Medicine
- Virology
Background:
- Viral infections transmitted via blood transfusion are a recognized but often underestimated risk.
- Healthcare professionals may overlook transfusion-transmitted viruses in patients presenting with post-operative febrile illnesses.
Observation:
- Two patients developed febrile illnesses approximately five weeks after surgery, following multiple perioperative blood transfusions.
- Initial diagnoses of typhoid fever and endocarditis were made, leading to inappropriate treatments.
Findings:
- Serologic testing confirmed cytomegalovirus infection in one patient and Epstein-Barr virus infection in the other.
- The review of literature indicates that transfusion-acquired viral infections are common, frequently presenting asymptomatically.
Implications:
- Highlights the importance of considering transfusion-transmitted viral infections in the differential diagnosis of post-operative fever.
- Emphasizes the need for enhanced vigilance and diagnostic protocols in transfusion medicine.
- Suggests that routine screening or awareness may be necessary to prevent iatrogenic viral transmission.