Volume 20, Number 8—August 2014
Dispatch
Dengue Virus Transmission by Blood Stem Cell Donor after Travel to Sri Lanka; Germany, 2013
Table
Timeline of events before and after allogeneic stem cell transplantation for patient and donor, Germany*
Time before (–.) and after (+) transplantation | Recipient event | Donor event |
---|---|---|
Month –5 | Diagnosis of poor risk acute myeloblastic leukemia and introduction of chemotherapy | Related donor assessment |
Months –5 to –2 | Consolidation chemotherapy | Unrelated donor search |
Month –2 | NA | Request of confirmatory typing (CT) and workup of the donor |
Day –28 | NA | Medical examination without any abnormalities |
Day –25 to day –9 | NA | Traveled to Sri Lanka |
Day –8 | Conditioning regimen started (defibrotide prophylaxis) | NA |
Day –5 | Klebsiella pneumoniae infection of the central venous catheter; catheter was removed and piperacillin/tazobactam was given | NA |
Day -6 to day –2 | NA | G-CSF mobilization of the donor |
Day –1 | NA | Stem cell collection; fever of unknown origin developed |
Day 0 | Transplantation of the stem cell graft; information about fever of the donor | Donor condition worsened suspect of tropical disease with thombocytopenia, skin rash and fever <41°C |
Day +3 | Fever and clinical signs of hepatic veno-occlusive disease with subsequent treatment | DENV infection confirmed by laboratory |
Day +7 | Staphylococcus epidermidis in blood cultures with subsequent vancomycin treatment | NA |
Day +8 | Hematochezia, metabolic acidosis, hypoxia, abdominal pain, and intensive care unit | Donor slowly recovered from DENV infection |
Day +9 | Patient died from enterocolitis/hepatic veno-occlusive disease | NA |
*NA, not applicable.