engleski

Fatal case of transfusion-transmitted Morganella morgagni sepsis from a pooled platelet transfusion

We reported a case o 46-year-old women with acute myeloid leukaemia who early after autologus hematopoetic stem cell transplantation experienced septic shock during the receiving the transfusion of a platelet pool contaminated with Morgane/lamorgagni. The patient collapsed after transfusion of few millilitres of platelets. Gram's stain of pooled platelets was negative. Morgane/lamorgagni were isolated from the platelet bag and patient's blood within 18 h of the acute event. Although antibiotics were administered immediate after reaction, the patient died 4 days after the platelets were transfused. The cause of death was cardiovascular shock and multiorgans failure. Nine trains originated from different body fluids and organs, which were taken at autopsy, were positive. Review of blood bank records showed that the platelet pool consisted of 6 individual donor units collected 5 days before transfusion. The units containing red cells and plasma had been recalled and were cultured. The Morgane/lamorgagni isolated from one recalled unit of red cells. The donor and the puncter were identified and their skin swab and stool were cultured. Culture of the donor's stool was yield Morgane/lamorgagni while swabs from donor's antecubital fossa and puncter's hand and stool were negative. Antimicrobial sensitivity of Morganelamorgagni isolated from transfusions bags and donor's stool allowed patient's blood and autopsy's strain seemed identical. To conform that we performed pulsed filed gel electrophoresis (PFEG) at all positive cultures. It showed that Morgane/lamorgagni from donor's stool and transfusion bag was the same as Morganella morgagni found in patient's fluids and organs at autopsy. Prompt reporting to the blood supplier, as illustrated by this case, may avoid the transfusion of other contaminated components from the same donation.

transfusion-transmitted Morganella morgagni sepsis, pooled platelet transfusion

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