Comment; Unlucky then lucky lady, exchange transfusion is not a common event–to say nothing of a “double-header”! The risks are significant as well–blood transfusion is a form of organ transplantation–there’s always a risk of a variety of potentially serious transfusion reactions–but it saved her life!
Christopher Radcliffea,,Correspondence information about the author Christopher RadcliffeEmail the author Christopher Radcliffe, Peter J. Krausea,b, Matthew GrantcPlumX MetricsDOI: https://doi.org/10.1016/j.transci.2019.07.010
Article Info
Abstract
We report a case of severe babesiosis presenting with 43% parasitemia in a 73-year-old splenectomized woman on etanercept for rheumatoid arthritis. She initially was treated aggressively with clindamycin and quinine and exchange transfusion. Despite a post-exchange drop in parasitemia to 7.6%, it rebounded to 11.4% on hospital day 5 accompanied by new onset high fevers and hypoxia. She improved after a second exchange transfusion and ultimately resolved her infection after 12 weeks of antibabesial antibiotics. Although exchange transfusion is commonly used in immunocompromised hosts, there is a dearth of information about repeat exchange transfusion, including the risk for and outcome of repeat exchange. We performed a literature search for other cases of repeat exchange transfusion for severe Babesia microti infection and compared our case with those in other published reports.
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