In 2011, a young organ donor became ill and was admitted to a healthcare facility in Florida and then died. At that time, the donorâs organs, including the kidneys, heart, and liver, were recovered and sent to recipients in Florida, Georgia, Illinois, and Maryland. These organs were tested thoroughly for suspected infectious agents, including HIV and hepatitis B and C viruses. In early 2012, the patient from Maryland, who received a kidney, became ill. He presented with diffuse twitching and was noted to be increasingly lethargic. During the next 24--48 hours, the patient had worsening mental status, seizures, hypotension, and respiratory failure requiring intubation. His mental status continued to deteriorate, and cerebral imaging 2 weeks after admission indicated severe cerebral edema. The patient subsequently died. Histopathologic examination of central nervous system (CNS) tissues revealed an encephalitis with viral inclusions suggestive of Negri bodies.
1.What do you believe caused the patientâs death?
2.Has this pathogen ever been indicated in an organ transplant case before?
3.What is the normal mode of transmission for this pathogen?
4.Why was the pathogen not revealed prior to organ transplantation? What factors make testing harvest organs difficult?
5.What do you think is the best course of action for the other organ recipients?
In 2011, a young organ donor became ill and was admitted to a healthcare facility in Florida and then died. At that time, the donorâs organs, including the kidneys, heart, and liver, were recovered and sent to recipients in Florida, Georgia, Illinois, and Maryland. These organs were tested thoroughly for suspected infectious agents, including HIV and hepatitis B and C viruses. In early 2012, the patient from Maryland, who received a kidney, became ill. He presented with diffuse twitching and was noted to be increasingly lethargic. During the next 24--48 hours, the patient had worsening mental status, seizures, hypotension, and respiratory failure requiring intubation. His mental status continued to deteriorate, and cerebral imaging 2 weeks after admission indicated severe cerebral edema. The patient subsequently died. Histopathologic examination of central nervous system (CNS) tissues revealed an encephalitis with viral inclusions suggestive of Negri bodies.
1.What do you believe caused the patientâs death?
2.Has this pathogen ever been indicated in an organ transplant case before?
3.What is the normal mode of transmission for this pathogen?
4.Why was the pathogen not revealed prior to organ transplantation? What factors make testing harvest organs difficult?
5.What do you think is the best course of action for the other organ recipients?
