Blood-Borne Dengue Virus: A Case Report of Severe Dengue in a Hematopoietic Stem Cell Recipient

Abstract

Background. Dengue virus (DENV) transmission through blood products is rare and screening is not a standard practice in blood banks, even in endemic countries. Methods. We retrospectively report a case based on clinical data record and laboratory findings. Results. We report the case of a patient diagnosed with lymphoblastic lymphoma who developed severe dengue following autologous hematopoietic stem cell transplantation (HSCT). She presented with severe hemorrhagic events, shock, and serositis. Three days after platelet transfusion, the donor reported to the medical team with classic symptoms of dengue fever. Blood analyses were positive for IgM against DENV in the donor and recipient samples, with RT-PCR revealing 178,602 and 8491 DENV RNA copies/ml, respectively. Transmission through platelet transfusion was confirmed by amplification and sequencing of the NS1 region of both viruses and comparisons with other samples, including samples from the same outbreak. Phylogenetic analysis demonstrated that viruses isolated from both the donor and HSCT recipient were identical in the sequenced region, supporting the hypothesis of blood component-transmitted dengue. Conclusion. Blood-borne DENV transmission may rarely result in severe case presentations. More studies are required to determine the incidence of DENV transmission by blood products and its relevance in public health. There is a substantial clinical need for new strategies for monitoring DENV transmission through blood transfusion during large outbreaks.