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Meningomyeloradiculitis following yellow fever 17D vaccination: a case report

Journal of NeuroVirology volume 24, pages 642–646 (2018)Cite this article

A Correction to this article was published on 17 September 2018

This article has been updated

Abstract

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.

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Fig. 1

Change history

  • 17 September 2018

    There was an error in the original article. In the last paragraph of the Case Report section, the sentence “One month later, two plasma exchanges were followed by only slight improvements in upper-limb motor function (Fig. 1).” should have been “One month later, four plasma exchanges were followed.

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Acknowledgments

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.

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Affiliations

  1. Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, 177 Rue de Versailles, 78150 Le Chesnay, Versailles, France

    Rody El Nawar, Andrei Girbovan, Jerome Servan & Fernando Pico

  2. Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon

    Rody El Nawar

  3. Department of Internal Medicine and Infectious Diseases, Centre Hospitalier de Versailles, Le Chesnay, France

    Perrine Bayle

  4. Department of Biology, Centre Hospitalier de Versailles, Le Chesnay, France

    Stephanie Juillet Marque

  5. Université Versailles Saint-Quentin en Yvelines et Paris Saclay, Versailles, France

    Fernando Pico

Authors
  1. Rody El Nawar
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  2. Perrine Bayle
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  3. Andrei Girbovan
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  4. Stephanie Juillet Marque
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  5. Jerome Servan
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  6. Fernando Pico
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Corresponding author

Correspondence to Rody El Nawar.

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The patient gave written informed consent to publication of this case report and of any accompanying photographs, under condition of anonymity.

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The authors declare that they have no conflict of interest.

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El Nawar, R., Bayle, P., Girbovan, A. et al. Meningomyeloradiculitis following yellow fever 17D vaccination: a case report. J. Neurovirol. 24, 642–646 (2018). https://doi.org/10.1007/s13365-018-0654-0

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  • DOI: https://doi.org/10.1007/s13365-018-0654-0

Keywords

  • Vaccine
  • Neuroimmunology
  • Virology
  • Meningomyeloradiculitis
  • Yellow fever