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Transfusion‐associated A naplasma phagocytophilum infection in a pregnant patient with thalassemia trait: a case report
Author(s) -
Shields Kelsey,
Cumming Melissa,
Rios Jorge,
Wong Michael T.,
Zwicker Jeffrey I.,
Stramer Susan L.,
Alonso Carolyn D.
Publication year - 2015
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12908
Subject(s) - leukoreduction , medicine , pregnancy , pediatrics , blood transfusion , thalassemia , incidence (geometry) , immunology , obstetrics , intensive care medicine , biology , genetics , physics , optics
Background Human granulocytic anaplasmosis ( HGA ) is an acute nonspecific febrile illness caused by the bacterium A naplasma phagocytophilum . Although usually transmitted via tick bite, HGA may rarely also be acquired through transfusion. HGA during pregnancy may pose significant gestational risks due to altered maternal immune status and the potential for perinatal transmission. Case Report A pregnant 34‐year‐old M assachusetts woman with β‐thalassemia trait was diagnosed at 32 weeks of gestation with transfusion‐associated HGA ( TAHGA ) after receiving nine leukoreduced red blood cell transfusions. She was successfully treated with rifampin therapy and gave birth to a healthy child who tested negative for HGA after delivery. An implicated blood donor was subsequently identified through physician collaboration with the regional A merican R ed C ross and M assachusetts D epartment of P ublic H ealth. Discussion This is the 11th reported case of HGA in pregnancy and is at least the sixth known case in which leukoreduction did not prevent TAHGA . As seen in this case, nonspecific symptomatology of variable onset can impede diagnosis and treatment. This may increase risk of poor outcomes in maternal HGA patients. Cases of TAHGA , although currently uncommon, may increase as the incidence of HGA in certain parts of the country increases. Conclusion Heightened cross‐institutional awareness of the potential risk of TAHGA is warranted. Clinicians need to consider transfusion‐associated infections when fever occurs in a transfusion recipient. This case provides additional evidence that leukoreduction does not obviate risk of A . phagocytophilum contamination of donated blood components.