A Layman
(From The Medical Record).
THE benefits of blood transfusion are as keenly appreciated by us in Sweden as by our Scandinavian and other neighbours, but we continue to be haunted by the possibilities of infection of the recipient by the donor. Some thirty-five cases of syphilis acquired by blood transfusion have already been recorded in the world literature, but with syphilis so rare in our midst, we are not particularly afraid of this sequel to transfusion, nor of malaria, which is practically unknown with us.
More than a decade ago, Dr. N. Hellstone, the Chief Medical Officer of the Swedish Ministry of Health, observed a case of pernicious anaemia which terminated fatally five days after the transfusion of the blood of a donor belonging to the same blood group. The donor developed slight fever in the evening of the day of the transfusion, and next day she had a sore throat from which swabs yielded staphylococci in pure culture.
Twenty-four hours after the transfusion she suffered from characteristic tonsillitis, with yellow plugs in the tonsils and a temperature of 39 degree C. Evidently in this case staphylococci in the donors blood had been pumped by the million into the recipients veins, and there could be no doubt that his death was due to rapidly progressive staphylococcal sepsis.
Now another remarkably similar case has just been reported from the Surgical Department of the Sabbatsberg Hospital in Stockholm by Dr. Torstein M. Beckman. His patient, who suffered from recurrent osteitis resulting from a compound fracture, was given an intravenous injection of blood from a donor who, three days after the transfusion, developed chicken-pox.
In this case, also, the fatal issue was evidently determined by a massive infection of the blood strain. How to avoid such tragedies in the future? Dr. Beckman has no sovereign remedy. He admits that it is difficult enough to diagnose an infectious disease during the incubation period, but he thinks it likely that “through examination of the blood, some of the unsuitable donors would be disclosed.”
The blood sedimentation test may prove useful in such cases, and its adoption as a routine measure in connection with blood transfusions would be all the more appropriate with us as this test was devised by a Swede, Robin Fahraeus.
