Meningomyeloradiculitis following yellow fever 17D vaccination: a case report
The yellow fever 17D vaccine contains live-attenuated virus. Initial efficacy and safety reports were favorable. Recently, however, neurologic and viscerotropic adverse events (AE) were described. We managed a 61-year-old man who experienced meningomyeloradiculitis 18 days after receiving the yellow fever 17D vaccine. The manifestations were atypical. The cerebrospinal fluid contained high titers of anti-yellow fever immunoglobulins M and G and of anti-flavivirus immunoglobulins G. After methylprednisolone (1 g/day for 3 days), intravenous human immunoglobulins (140 g over 5 days), and two plasma exchanges, the symptoms improved only slightly. Neurological adverse events after yellow fever vaccination are rare or underestimated. To our knowledge, this is the first reported case of meningomyeloradiculitis after yellow fever vaccination. A remarkable feature is the intrathecal production of yellow fever antibodies, which probably played a pathogenic role and may have been related to a recent episode of influenza.
KeywordsVaccine Neuroimmunology Virology Meningomyeloradiculitis Yellow fever
We thank Dr. Isabelle Leparc-Goffart, PhD, HDR and the National Arbovirus Reference Center, Laveran Hospital, Marseille, France, for the support and advice and the Centre Hospitalier de Versailles for the editorial assistance.
The manuscript has not been published previously and is not being considered for publication elsewhere.
Compliance with ethical standards
The patient gave written informed consent to publication of this case report and of any accompanying photographs, under condition of anonymity.
Conflict of interest
The authors declare that they have no conflict of interest.
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