A 48-year-old man with a history of pancreatic cancer who underwent distal pancreatectomy and splenectomy 4 months ago presents with fatigue, weakness, pallor, and dyspnea on exertion. On hospital admission, the patient is found to be severely anemic with a hemoglobin (Hgb) of 5.6 g/dL and a lactate dehydrogenase (LDH) level of 1180 U/L, total bilirubin level of 6.4 mg/dL, haptoglobin level less than 7 mg/dL, and a reticulocyte count of 16.2%. The blood bank history shows that the patient had received two units of red blood cells (RBCs) post pancreatectomy (one on postoperative day #1 and the second on postoperative day #2); the preoperative antibody screen was negative. A type and screen (ethylenediaminetetraacetic acid [EDTA] anticoagulant) sample is submitted to the blood bank along with a request for crossmatch of two units of RBCs for transfusion.
KeywordsBabesia microti Babesiosis Exchange transfusion Malaria Plasmodium falciparum
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