Resumen

LOPEZ DE GUIMARAES, Douglas; MENACHO L, Julio; PAREDES R, Walter  y  MAGUINA V, Ciro. Daño pulmonar agudo relacionado con la transfusión (Trali) y Bartonelosis aguda. Rev. perú. med. exp. salud publica [online]. 2006, vol.23, n.3, pp.225-229. ISSN 1726-4634.

A 22-year old, male patient from the outskirts of the city of Huaraz was seen at Hospital "Victor Ramos Guardia" in Huaraz. He had been ill for 14 days, febrile, pale and jaundiced. The peripheral blood smear showed bacillary forms of Bartonella bacilliformis in 99% of the slide. Antibiotic treatment was started with ceftriaxone and ciprofloxacin. The following day, two globular packages of blood were transfused to him (because he had 6,2 g/dL hemoglobin). Two hours later, he presented with thoraxic pain, demanding dry cough, vomiting, respiratory distress and cianosis. Upon the physical examination, crepitant and ronchi, the chest x-ray showed a diffuse alveolar infiltrate, predominantly in the right side. He was transferred to the ICU and given oxygen with a reservoir mask, dopamine, corticoids and hemodynamic monitoring was initiated. The patient responded satisfactorily and was released with a Bartonella bacilliformis negative smear. This is the first case of transfusion-related acute lung injury (TRALI), associated with acute Bartonellosis with a clinical and radiological presentation. It is important to distinguish this from the pulmonary complication due to severe sepsis due to acute Bartonellosis, which may have a similar presentation.

Palabras clave : Bartonella infections; Blood component transfusion; Acute distress respiratory syndrome.

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