TRANSFUSION-TRANSMITTED YERSINIA SEPTICEMIA

After a primary operation for renal artery stenosis a 48-year-old woman had to be reoperated twice for renewed arterial stenosis and retroperitoneal bleeding. The patient's respiratory and cardiovascular functions were stable two days after the second operation and renal function was recovering. But because of suspected renewed bleeding a transfusion with erythrocyte concentrate was begun. Fifteen minutes later the patient started to shiver and this was followed by signs of cardiocirculatory decompensation under the picture of a septic-toxic shock. Laboratory tests did not indicate a haemolytic transfusion reaction. Controlled mechanical ventilation and circulatory drug support were required over the next two days, renewed anuria persisting for longer than a week. Microbiological test of the erythrocyte concentrate demonstrated Yersinia enterocolitica, serotype 03. Questioning of the blood donor revealed a mild gatroenteritis at the time of donation. This case underlines the need of excluding donors, if only temporarily, when there is even slight suspicion of a Yersinia infection.