Transfusion-Transmitted Yersinia enterocolitica Sepsis

Bacterial sepsis has become the most frequent infectious complication of transfusion. Although Yersinia enterocolitica is a common enteropathogen usually causing relatively mild disease, it is nevertheless a prominent cause of life-threatening post-transfusion infection. To gain a better understanding of the clinical presentation and prognosis of this rare occurrence, we performed a systematic and detailed review of 55 published cases, which we present here after a description of the mechanisms underlying the contamination of red blood cell preparations by Y. enterocolitica. The symptoms are rapid-onset septic shock sometimes heralded by atypical symptoms, such as explosive diarrhea, with an overall fatality rate of 54.5%. Although the pathophysiology involves transfusion of preformed bacterial endotoxin, timely administration of effective antibiotics seems to improve the prognosis. Increased vigilance of the blood supply could help mitigate this transfusion hazard, although cost-effective strategies are difficult to define for this highly serious but infrequent event.