Female, 21 years, 20 weeks pregnant Sickle cell disease but

Patient

Q: Female, 21 years, 20 weeks pregnant. Sickle cell disease but without the usual problems like frequent pain in joints and such. Admitted to the hospital for 6.7 hemoglobin count and 56,000 platelets. One dosage (small bag) of blood transfused and 3 vaccine shots were given (Heptites B DNA, Meningococcal and Pneumoccal Conjugate (Prevnar13)). Around 5 days later develops fever (~38C) and diarrhea. Went to ER and they admitted here because of low Hemoglobin (5.2, Platelets ~80) They reduced fever and gave her one dosage (small bag) of blood. A couple of hours she starts passing blood with the urine, severely. No back pains or other symptoms there. Blood and platelet Transfusion is done again and blood count rises to 5.9 but still bloody urine, more like urinating blood. Over 24 hours period, give or take, diarrhea and fever subsided, urine clears out but blood is very low (3.2 Hemoglobin).

Could you please identify what went wrong and what is the best way to proceed?

Thank you,

Symptoms:  Dizziness and elevated heart rate. Fever and diarrhea (subsided)
Doctor

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