Case 39

1. Presented by Eric A. Gehrie, MD and prepared by Lorraine N. Blagg, MA, MLS(ASCP)SBB

Clinical Vignette

An O positive elderly patient was readmitted due to worsening symptoms from pneumonia. Six days later, the patient received two apheresis platelet transfusions from the same donor for a procedure. The patient received the entire first platelet product and 90% of the second unit when the patient experienced nausea and vomiting, headache, chills/rigors, chest pain and back pain. The patient's temperature increased from 35.9C pre transfusion to 37.3C post transfusion, blood pressure increased from 110/54 to 145/80, oxygen saturation remained stable, and there was no presence of rash, hives, or itching. A transfusion reaction was reported to the transfusion service.

The clerical check was correct, the remaining platelet product had a gram stain, aerobic, and anaerobic culture prepared. The microbiology laboratory reported the gram stain as positive with gram-negative cocci in clusters.


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