Adverse Occurrence type:
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Fever developed day 2 after BMT but resolved by day 4. On day 4 the culture of the BM infusion grew Brucella abortus, type III, but no specific therapy was given to patient. Day 10 fever 39.5C, chills, elevated ALT, AST developed. On day 19 recipient blood cultures grew Brucella and after treated with doxycycline and gentamcin sypmtoms resolved.
Demonstration of imputability or root cause:
Proven. Brucella abortus grew in donor blood and donated marrow and in recipient blood. Recipient with Fanconi anemia developed fever, altered LFT, positive blood culture. Donor was 3.5 year old brother who returned 32 days after donation, had mildly enlarged liver and spleen and elevated liver enzymes and a Brucella antibody titer of 1:320. Donor blood cultures were positive for B abortus. He has eaten cheese made from unpasteurized cow milk 4-6 weeks before the donation. The cheese had been stored in salt 8-10 weeks before being eaten.