Subject(s)
Cat-Scratch Disease/diagnosis , Ear Canal , Foreign Bodies/diagnosis , Mesothelioma, Cystic/diagnosis , Peritoneal Neoplasms/diagnosis , Arthralgia/etiology , Cat-Scratch Disease/complications , Cat-Scratch Disease/drug therapy , Child , Female , Foreign Bodies/therapy , Hip Joint , Humans , Immunocompromised Host , Magnetic Resonance Spectroscopy , Male , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Currently, individuals donating whole blood and cellular components are not screened for hepatitis A (HA). However, transfusion-transmitted HA can occur, albeit very rarely. Although infection is typically mild and self-limited, it may be catastrophic in a small percentage of cases. Two cases of HA transmission from a single donation to two patients with subsequent variable morbidity are reported. CASE REPORTS: A 50-year-old, asymptomatic, volunteer blood donor made a whole-blood donation. He was found to have HA 18 days later. When notified, the donor center initiated a recall of the components produced from the donated unit. However, the RBCs and FFP had already been transfused. Subsequently, both recipients developed HA as documented by IgM anti-HA serology. The RBC recipient was a 49-year-old woman, transfused after a hysterectomy, who was found to have HA at the time of unit recall (20 days after transfusion). Her condition required the use of medical disability leave. The FFP was infused to a 52-year-old female cardiac surgical patient. Her course was marked by multiple complications, including postoperative development of mild hepatic dysfunction. After testing negative for HA, hepatitis B, and hepatitis C (24 days after transfusion), she suffered a second bout of more severe hepatic dysfunction and was documented to have HA at Day 55 after transfusion. Evaluation of both recipients' close contacts revealed no evidence for exposure to HA by any route other than transfusion. CONCLUSION: HA can be transmitted by transfusion of units obtained from asymptomatic, infectious donors. Two patients contracted HA from components obtained from a single whole-blood donation. The RBC recipient had a typical self-limited course of HA. The FFP recipient developed HA of relatively delayed onset. Both recovered from HA.
Subject(s)
Blood Component Removal , Blood Donors , Erythrocyte Transfusion/adverse effects , Hepatitis A/transmission , Leukocytes , Plasma , Alanine Transaminase/blood , Alkaline Phosphatase/blood , Aortic Valve Stenosis/surgery , Aspartate Aminotransferases/blood , Bilirubin/blood , Fatal Outcome , Female , Heart Valve Prosthesis , Hepatitis A/diagnosis , Hepatitis A Antibodies/blood , Humans , Hysterectomy , Male , Middle Aged , Mitral Valve Stenosis/surgeryABSTRACT
A previously healthy 4-year old male, born in India and residing in Mobile, Alabama since October 1996 came to the emergency department in April 1997 because of general malaise, fever and vomits of 5 days duration. A peripheral smear of the complete blood count revealed the presence of malarial parasites within the erythrocytes. Plasmodium vivax was later identified in serial thin peripheral smears. He defervesced after initial treatment with oral quinine and pyrimethamine-sulfadoxine, followed by primaquine for 14 days.
