Sex: F
Vaccine: VARCEL, YF
Symptoms: Blister, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site vesicles
Clinical narrative: Initial unsolicited report received from the literature on 23-Oct-2017. This case is linked with: 2017SA207244, 2017SA207248, 2017SA207251, 2017SA207263, 2017SA207267, 2017SA207271, 2017SA207279, 2017SA207273, 2017SA207277, 2017SA207282, 2017SA207280. (Same literature). Abstract: Yellow fever vaccine is a live attenuated viral inoculation indicated for patients traveling to endemic areas. The vaccine is generally well tolerated with minimal adverse effects. Typical side effects include malaise, pain at the injection site, and, albeit rarely, immediate hypersensitivity reactions. We present a case of a rare adverse reaction to yellow fever vaccine in which a patient developed vesicular lesions resulting in bullae and circumferential hyperpigmentation. This case involves a 37-year-old female patient, who was vaccinated with a dose of YELLOW FEVER VACCINE (YELLOW FEVER) (batch number, expiry date, dose, dose in series were not reported) subcutaneously in left arm and dose two of VARICELLA VACCINE (LIVE) (VARICELLA) (batch number, expiry date, dose, dose in series were not reported) subcutaneously in left arm on 14-Mar-2012 around noon. Patient had no current illness and preexisting conditions were reported as NKDA, SAR (seasonal allergic rhinitis) (spring/fall), Cervical herniation C3-C7 with cervical stenosis C5-C7 dx upon return from work. Feb-2012 Surgical Decompression L3-L5, GERD (Gastroesophageal reflux disease), and nephrolithiasis. It was reported as the patient endorses history of chicken pox (disease) at 13-14 yrs. of age. Concomitant medications were reported as Montelukast (Singulair) 10 mg daily orally for SAR, Celecoxib (Celebrex) 200 mg daily orally, Gabapentin (Neurontin) 300 mg daily orally, Ethinylestradiol/norgestimate (Orthotricyclen low), per clinic guidance, PCM advised patient to hold CELEBREX and start Ibuprofen 800 mg daily three times a day orally, and add Omeprazole 20 mg daily orally while taking to prevention. On 15-Mar-2012, one day after the vaccination, patient developed injection site erythema and pruritus with 11 x 13 cm area of erythema and swelling on posterior aspect of left arm, extending from patient left axilla to just above patient left elbow, and as per the doctor, there are also some small pruritic, fluid-filled vesicles/blisters over the initial area of redness, warmth and itching, which measured 4x6 cm in size and is demarcated with a black pen and patient also developed low grade fever and malaise. On 16-Mar-2012, patient presented to the clinic with growing area of erythema and patient erythema, swelling, warmth and pruritus have increased to 11 x 13 cm, extending from patient left axilla to just above her left elbow and as per the doctor blistering around the injection site, with impressive increase in erythema and swelling was observed, the patient had no induration, fluid wave or visible pus. It was reported as on 21-Mar-2012, during the follow up visit patient stated that she found her old Yellow Immunization Card which indicated that she also received a dose of varicella on an unknown date in Oct-2006 before going to work. No laboratory examinations were performed to the patient. Patient corrective treatment was not reported. On an unknown date, patient recovered from all the events. List of documents held by sender: none.