Clinical Presentation - Bacterial Sepsis
Some symptoms are similar to immune-mediated immediate hemolytic transfusion reactions and transfusion-related acute lung injury (TRALI). Milder reactions may be indistinguishable from febrile non-hemolytic transfusion reactions. The degree of severity relates to many factors, including the virulence of the organism, bacterial load infused, and host factors such as coincidental antibiotic therapy and level of immunosuppression.
Symptoms generally appear during or immediately after transfusion and may include:
- fever
- rigors
- nausea
- vomiting
- diarrhea
- dyspnea
- tachycardia
- lumbar pain
- rise or drop in systolic pressure
- shock
- circulatory collapse
- oliguria
- uncontrolled bleeding due to Disseminated Intravascular Coagulation (DIC)
Mechanism
Bacterial endotoxins stimulate macrophages, which in turn secrete cytokines such as tumour necrosis factor (TNF- , interleukin-1, IL-6, IL-8, etc. Cytokine release causes the signs and symptoms and may lead to acute septic shock.