ACUTE GRANT-NEGATIVE UROSEPSIS MIMICKING AN ACUTE HEMOLYTIC TRANSFUSION REACTION

Background: The acute hemolytic transfusion reaction (AHTR) is one of the most feared complications of blood transfusion; Over the years, se veral clinical conditions, as well as errors in blood component prepar ation and administration, that mimic AHTR have been identified. This r eport describes a novel variation on the theme of pseudo-AHTR. Case Re port: A 47-year-old diabetic man with drug-induced pancytopenia sudden ly manifested severe shaking chills, flank pain, and back pain during a red cell transfusion, The passage of bright red urine immediately af ter the transfusion virtually confirmed for the clinicians administeri ng the transfusion that an AHTR had occurred. In the laboratory, the h ematuria was shown to be due principally to red cells and not to free hemoglobin. Further posttransfusion work-up showed a urinary tract inf ection and overwhelming bacterial sepsis with Escherichia coli. Conclu sion: As a pseudo-AHTR, gram-negative bacterial sepsis of urinary trac t origin may surpass other forms of sepsis; Urosepsis should be consid ered in the work-up of a suspected AHTR in a pancytopenic patient with a urinary tract infection.