Type 2M VWD is more often misidentified (70.6%) than correctly identified as 2M VWD (29.4%), and potentially explaining the relative under-reported incidence of 2M VWD in the literature.

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The diagnosis of microbial-induced T (Thomsen-Freidenreich) red blood cell (RBC) cryptantigen exposure and polyagglutinability and management of transfusion therapy for such patients poses a potential clinical problem. These phenomena are often not detectable by standard cross-matching techniques and may go unrecognized unless specific testing prompted by the clinical setting is performed. Infusion of standard plasma-containing blood products (a rich source of IgM anti-T) may cause intravascular haemolysis, renal failure and death in some cases l. \ or be uneventfuP. Thus there is debate regarding the need for transfusion precautions 6 ,7. The lack of tests to predict those who will react adversely to plasma products further complicates this tissue. We report a case and discuss these findings and their impact on the management of a patient with complex medical and surgical problems. CASE REPORT A 69-year-old female was transferred to the intensive care unit from another institution with complications arising from cardiac surgery performed 45 days previously. Clinical examination and subsequent investigations revealed a sternal wound infected