Sex: U
Vaccine: DTAP, HEP, HIBV, HPVX, MMR, MNQ, OPV, VARCEL
Symptoms: Conjunctivitis, Otitis media, Pharyngitis, Pneumonia, Pseudomonas infection
Clinical narrative: This case was reported in a literature article and described the occurrence of pseudomonas in a subject of unspecified age and gender born between 1974 and 2008 who was vaccinated with DTPa (small content), (manufacturer unspecified), Hib vaccine, Hepatitis B vaccine, poliomyelitis vaccine live oral (non-gsk), MMR vaccine (non-gsk), varicella virus vaccine (non-gsk), HPV vaccine and (non-gsk) MENACTRA. Concurrent medical conditions included DiGeorge's syndrome and had a chromosome 22q11.2 microdeletion detected by fluorescence in situ hybridization assay. No further information on the subject's medical, family history or concurrent medication is available. On an unspecified date, the subject received an unspecified dose of MMR vaccine (Non-GSK) (unknown) and an unspecified dose of Varicella virus vaccine (Non-GSK) (unknown). 14 days after vaccination with MMR vaccine and Varicella virus vaccine, the subject experienced pneumonia, fever, conjunctivitis and viral illness. On an unspecified date, the subject received an unspecified dose of DTPa (small content) (administration site and route unknown, batch number not provided), an unspecified dose of Hib vaccine (administration site and route unknown, batch number not provided), an unspecified dose of Hepatitis B vaccine (administration site and route unknown, batch number not provided) and an unspecified dose of Poliomyelitis vaccine live oral (Non-GSK) (oral). 36 days after, the subject experienced fever and upper respiratory infection. 7 days later, the subject experienced pseudomonas (tracheostomy discharge). On an unspecified date, the subject received an unspecified dose of MMR vaccine (Non-GSK) (unknown). 47 days after, the subject experienced pneumonia, fever, otitis media, pharyngitis and conjunctivitis. 3 days later, the subject was hospitalised. On an unspecified date, the subject received an unspecified dose of HPV vaccine (administration site and route unknown, batch number not provided), an unspecified dose of MENACTRA (unknown), an unspecified dose of DTPa (small content) (unknown) and an unspecified dose of Varicella virus vaccine (Non-GSK) (unknown). 34 days after, the subject experienced rash. It was not possible to know exactly after which doses the events occurred. The chronology was unclear. It was supposed that the episodes of pneumonia resolved before administration of subsequent vaccines. No information has been provided regarding any examination or investigation performed on the subject. At the time of reporting, the outcome of the events was unspecified. According to the Modified WHO Causality Criteria, rash was unrelated to vaccination with varicella vaccine, pneumonia was unrelated to OPV vaccine and unlikely related to MMR and varicella vaccine. The author's conclusion stated that their data expanded the findings of smaller studies indicating that live vaccination of patients with DGS with mild-to-moderate immunosuppression was well-tolerated. Prospective studies are needed to confirm their findings and offer guidance for live vaccination. Because this study included few patients with DGS with severe immunosuppression, further retrospective investigation of this population is warranted. This case is one of the 18 cases reported in the same literature article.