During the transfusion of pooled platelets, a patient develops abdominal cramps and nausea. What do these symptoms most likely indicate?

The symptoms of abdominal cramps and nausea during the transfusion of pooled platelets are most indicative of bacterial contamination. In cases of bacterial contamination, patients can present with gastrointestinal symptoms due to the release of toxins from bacteria present in the transfused products. The rapid onset of these symptoms during or shortly after transfusion can suggest that the platelets were contaminated with viable bacteria, leading to a systemic inflammatory response. This contrasts sharply with other types of transfusion reactions.

In febrile non-hemolytic transfusion reactions, symptoms primarily include fever and chills, often accompanied by a rash, but abdominal cramps and nausea are not typical findings. A hemolytic transfusion reaction is characterized by fever, chills, flank pain, and dark urine due to hemolysis of red blood cells, which does not align with the gastrointestinal symptoms presented. Transfusion-related acute lung injury (TRALI) is associated with respiratory distress and hypotension, not gastrointestinal symptoms. Understanding these distinct presentations is crucial in identifying the underlying cause of symptoms during transfusions.