Age: 20.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Leukocytosis, Vomiting
Clinical narrative: This case was reported in a literature article and described the occurrence of inflammatory reaction in a 20-year-old male patient who received Influenza vaccine. Co-suspect products included Pneumococcal vaccine for smoker. Concurrent medical conditions included smoker. On an unknown date, the patient received Influenza vaccine and Pneumococcal vaccine. On an unknown date, less than a day after receiving Influenza vaccine, the patient experienced inflammatory reaction (serious criteria hospitalization), injection site erythema, injection site edema, injection site warmth, body temperature increased, vomiting, rigors and extensive swelling of vaccinated limb (serious criteria hospitalization). The patient was treated with Antibiotics Therapy (Unknown). On an unknown date, the outcome of the inflammatory reaction, body temperature increased, vomiting and rigors were recovered/resolved and the outcome of the injection site erythema, injection site edema, injection site warmth and extensive swelling of vaccinated limb were recovering/resolving. It was unknown if the reporter considered the inflammatory reaction, injection site erythema, injection site edema, injection site warmth, body temperature increased, vomiting, rigors and extensive swelling of vaccinated limb to be related to Influenza vaccine. Additional information received: This case was reported in a literature article and it described the occurrence of systemic inflammatory reaction in a 20-year-old male patient who had received an unspecified influenza vaccine and an unspecified pneumococcal vaccine (manufacturers unknown). The patient was a smoker at the time of the event and he had received the pneumococcal vaccine for that reason. The patient had not received the pneumococcal vaccine previously. No further information on the patient's concurrent medical conditions, medical and family history or concomitant medication was provided by the authors. On an unspecified date, the patient received an unspecified influenza vaccine and an unspecified pneumococcal vaccine (dosages unknown; both vaccines were administered in the same arm; batch numbers not provided). On an unspecified date, within 1 day of the administration of the vaccines, the patient developed severe local erythema, oedema and warm at the pneumococcal and influenza vaccines administration sites to the extent that treatment was commenced for presumed cellulitis. In addition to this the patient also suffered an increase in the temperature up to 103 deg. F (within 1 day of the vaccination), rigors and vomiting. The local reaction expanded well beyond the injection site by day 3-4 post-vaccination. The patient sought medical attention and was admitted to hospital for observation and antibiotic treatment. Once there he was found to have a leukocytosis with a predominance of neutrophils. The patient experienced an improvement in the skin problems and a resolution of the systemic symptoms within 5-7 days, and was eventually discharged home on antibiotics. This was a serious case as the patient required hospitalisation. The patient white blood cell count at the time of the event was 22.8 x 10E3/uL. Treatment consisted of full courses of unspecified antibiotics to cover for common skin flora as well as methicillin-resistant Staphylococcus aureus as the patient believed to be suffering from cellulitis. The outcome of the skin conditions was improvement within 5-7 days. Outcome of the systemic events was resolution within 5-7 days. The authors believed that the reactions were due to the pneumococcal vaccine based on its known side effects, the lack of similar findings in patients who receive the influenza vaccine in isolation and patient's lack of influenza vaccine-associated local symptoms. The authors concluded that "this case series highlights potential side effects of the pneumococcal vaccine that are not well described in the adult literature. Antibiotics were not helpful in treating these patients' local and systemic symptoms. Patients with histories consistent with that highlighted in this case series may avoid antibiotics and hospitalization if their providers recognize these symptoms as a non-infectious reaction to the pneumococcal vaccine". This case is 1 of the 5 valid cases reported in the same literature article (see case US2015GSK149063).