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J Natl Med Assoc. 2006 October; 98(10): 1697–1699.
PMCID: PMC2569743

Fatal delayed transfusion reaction in a sickle cell anemia patient with Serratia marcescens sepsis.


Patients with sickle cell anemia may require repeated red cell transfusion, putting them at risk for minor blood group alloimmunization and the development of delayed hemolytic transfusion reactions. Although Streptococcus pneumoniae is the most common cause of life-threatening infection in patients with sickle cell anemia, those who have been recently hospitalized are at risk for infection with resistant hospital-associated organisms, and blood transfusion may put the patient at risk of infection with transfusion-associated organisms such as Serratia marcescens and Yersinic enterocolitica. We recently cared for an adolescent with sickle cell anemia who presented to the emergency department with a severe, delayed hemolytic transfusion reaction and Serratia marcescens infection. The patient had been discharged from the hospital five days previously, and had been transfused and treated with antibiotics while hospitalized. In addition to demonstrating the potential severity of delayed hemolytic transfusion reactions, our case illustrates the importance of providing relatively broad-spectrum antibiotic coverage to patients with sickle cell anemia and possible infection who have recently been hospitalized.

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Selected References

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  • Talano Julie-An M, Hillery Cheryl A, Gottschall Jerome L, Baylerian Diane M, Scott J Paul. Delayed hemolytic transfusion reaction/hyperhemolysis syndrome in children with sickle cell disease. Pediatrics. 2003 Jun;111(6 Pt 1):e661–e665. [PubMed]
  • Petz LD, Calhoun L, Shulman IA, Johnson C, Herron RM. The sickle cell hemolytic transfusion reaction syndrome. Transfusion. 1997 Apr;37(4):382–392. [PubMed]
  • Rosse Wendell F, Narla Mohandas, Petz Lawrence D, Steinberg Martin H. New Views of Sickle Cell Disease Pathophysiology and Treatment. Hematology Am Soc Hematol Educ Program. 2000;NaN(NaN):2–17. [PubMed]
  • Win N, Doughty H, Telfer P, Wild BJ, Pearson TC. Hyperhemolytic transfusion reaction in sickle cell disease. Transfusion. 2001 Mar;41(3):323–328. [PubMed]
  • Pineda AA, Taswell HF, Brzica SM., Jr Transfusion reaction. An immunologic hazard of blood transfusion. Transfusion. 1978 Jan-Feb;18(1):1–7. [PubMed]
  • Garratty George, Telen Marilyn J, Petz Lawrence D. Red cell antigens as functional molecules and obstacles to transfusion. Hematology Am Soc Hematol Educ Program. 2002:445–462. [PubMed]
  • Aken'ova YA, Bakare RA, Okunade MA. Septicaemia in sickle cell anaemia patients: the Ibadan experience. Cent Afr J Med. 1998 Apr;44(4):102–104. [PubMed]
  • Wierenga KJ, Hambleton IR, Wilson RM, Alexander H, Serjeant BE, Serjeant GR. Significance of fever in Jamaican patients with homozygous sickle cell disease. Arch Dis Child. 2001 Feb;84(2):156–159. [PMC free article] [PubMed]
  • Bernini JC, Mustafa MM, Sutor LJ, Buchanan GR. Fatal hemolysis induced by ceftriaxone in a child with sickle cell anemia. J Pediatr. 1995 May;126(5 Pt 1):813–815. [PubMed]
  • Bochud Pierre-Yves, Bonten Marc, Marchetti Oscar, Calandra Thierry. Antimicrobial therapy for patients with severe sepsis and septic shock: an evidence-based review. Crit Care Med. 2004 Nov;32(11 Suppl):S495–S512. [PubMed]

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