Late postoperative fever--viral infection following multiple blood transfusion.

The possibility of acquiring a viral infection by blood transfusion, although recognized for nearly 20 yr, is often ignored. Surgeons and internists submit patients to sophisticated, and sometimes invasive, diagnostic and therapeutic procedures without considering this possibility. We report here on two patients in whom febrile illness appeared about 5 wk after surgery. Both had received multiple blood transfusions in the perioperative period. Initial diagnoses indicated typhoid fever in one patient who received chloramphenicol therapy, and endocarditis in the other patient who was given massive combined antibiotic therapy. Both were later diagnosed by serologic methods as having cytomegalovirus and Epstein-Barr virus infection, respectively. Review of the literature reveals that this mechanism of acquiring these frequently asymptomatic viral infections is surprisingly common.