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Volume 20, Number 8—August 2014

Dengue Virus Transmission by Blood Stem Cell Donor after Travel to Sri Lanka; Germany, 2013

Michael Punzel, Gülay Korukluoğlu, Dilek Yagci Caglayik, Dilek Menemenlioglu, Sinem Civriz Bozdag, Emre Tekgündüz, Fevzi Altuntaş, Renata de Mendonca Campos, Bernd Burde, Stephan Günther, Dennis Tappe, Daniel Cadar, and Jonas Schmidt-ChanasitComments to Author 
Author affiliations: MediaPark Klinik, Cologne, Germany (M. Punzel); Public Health Institutions of Turkey, Ankara, Turkey (G. Korukluoğlu, D.Y. Caglayik, D. Menemenlioglu); Abdurrahman Yurtarslan Ankara Oncology Hospital, Ankara (S.C. Bozdag, E. Tekgündüz, F. Altuntaş); Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (R. de Mendonca Campos); Medizinisches Versorgungszentrum Labor Dr. Quade & Kollegen, Cologne (Bernd Burde); Bernhard Nocht Institute for Tropical Medicine, World Health Organization Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Hamburg, Germany (S. Günther, D. Tappe, D. Cadar, J. Schmidt-Chanasit); German Centre for Infection Research, Hamburg-Luebeck-Borstel, Hamburg (J. Schmidt-Chanasit)

Main Article


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.

Main Article

Page created: July 18, 2014
Page updated: July 18, 2014
Page reviewed: July 18, 2014
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