Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Blood glucose, C-reactive protein increased, Computerised tomogram, Malaise
Clinical narrative: Postoperative wound infection; Malaise; Right shoulder pain; This literature-non-study case was reported in a literature article and describes the occurrence of POSTOPERATIVE ABSCESS (Postoperative wound infection) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. LITERATURE REFERENCE: The patient's past medical history included Constipation (He had some initial issues with constipation that had resolved, but otherwise unremarkable. His postoperative course initially was unremarkable. Prophylactic Clindamycin had been given. He was also given 2 more doses while in the hospital) in 2021, Arthroscopic surgery (He underwent a right shoulder Arthroscopic debridement with biceps surgery after 6 years of conservative treatment. He continued to have pain and presented for definitive shoulder arthroplasty 4 years later), Shoulder arthroplasty (He underwent routine right shoulder anatomic total shoulder arthroplasty in early March of 2021.) in March 2021 and Debridement (The patient was then immediately taken to the operating room on Post operative day(POD) 51 for open irrigation and debridement. There was noted to be superficial purulence which did track down to disrupt 30% of the subscapularis repair. There was no evidence of intra-articular purulence. More cultures were taken prior to antibiotic administration. The implants were well fixed and retained  A second open irrigation and debridement were performed on POD 53 The aspirate from  POD 50 included testing for alpha defensin, which was positive. The cultures grew Cutibacterium acnes at 2 weeks post-surgery and oral antibiotics were prescribed.). Concurrent medical conditions included Diabetes (Controlled type 2 diabetes) and Shoulder osteoarthritis (Patient has been followed by the primary surgeon for over 10 years for bilateral shoulder osteoarthritis). Concomitant products included CLINDAMYCIN for Arthroplasty (excl hip or knee).    On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced POSTOPERATIVE ABSCESS (Postoperative wound infection) (seriousness criterion hospitalization), MALAISE (Malaise) and ARTHRALGIA (Right shoulder pain). At the time of the report, POSTOPERATIVE ABSCESS (Postoperative wound infection) and MALAISE (Malaise) outcome was unknown and ARTHRALGIA (Right shoulder pain) had not resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In March 2021, Blood glucose: serum glucose levels were well controlled His serum glucose levels were well controlled while in the hospital. He was discharged home on POD 1.. On an unknown date, C-reactive protein increased: increased 1.4 normal range was less than .9. On an unknown date, Computerized tomogram: a preoperative ct scan was obtained to confirm the A preoperative CT scan was obtained to confirm the diagnosis and allow for templating for shoulder arthroplasty. and a ct scan was obtained looking for a deep abscess A CT scan was obtained looking for a deep abscess which was not identified. On an unknown date, Red blood cell sedimentation rate abnormal (0-15): increased 50. On an unknown date, White blood cell count (5.7-10.5): normal (normal) 8.2.     For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered POSTOPERATIVE ABSCESS (Postoperative wound infection), MALAISE (Malaise) and ARTHRALGIA (Right shoulder pain) to be related.    Patient  noticed an almost immediate increase in his right shoulder pain at that time which had persisted. Patient had not been taking narcotics for several weeks, but patient now needed narcotics to manage the pain was reported. Patient had not received any prior cortisone injections or invasive treatment to the shoulder since the arthroscopic procedure. The patient completed the course of oral antibiotics at 6 months post-surgery. At clinical follow-up, the patient had regained 130 degrees of active elevation and reported less pain in the surgical shoulder than the contralateral shoulder which also has known glenohumeral osteoarthritis  Company Comment: This is a literature case concerning 68  year  old, male patient with medical history of type II diabetes mellitus and bilateral shoulder osteoarthritis with arthroplasty of his right shoulder, who experienced the unexpected, serious (due to hospitalization) event of postoperative abscess, among other non  serious events. The event occurred approximately three weeks after the administration of a dose of mRNA  1273 vaccine, considered as the second dose of his COVID - 19 vaccine schedule. No details of previous doses were provided. The patient had an arthroplasty and 50 days after surgery, in his postoperative control, he referred that after vaccination with mRNA  1273 he was malaise for several days and noticed an increase in his right shoulder pain, for which he needed narcotics as treatment. On an unspecified date the patient developed redness surrounding his incision, and in the examination an apparent central abscess was demonstrated. Fluid was aspirated and he was taken twice to the operating room for irrigation and debridement where it was noted purulence which disrupt 30% of the subscapularis repair. In the cultures taken from surgery C. acnes was developed, for which he was treated with an unspecified antibiotic (he completed 6 months of oral treatment). Patient´s medical history of type 2 diabetes mellitus and previous arthroplasty could be confounders confounder for postoperative abscess. The Benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.   This case was linked to MOD-2022-461948 (Patient Link).   Most recent FOLLOW-UP information incorporated above includes: On 05-May-2022: Follow up received by safety on 05-May-2022 has Email received from team and contains significant information. Reporter information, current condition, event, seriousness and treatment updated. Sender's Comments: This is a literature case concerning 68  year  old, male patient with medical history of type II diabetes mellitus and bilateral shoulder osteoarthritis with arthroplasty of his right shoulder, who experienced the unexpected, serious (due to hospitalization) event of postoperative abscess, among other non  serious events. The event occurred approximately three weeks after the administration of a dose of mRNA  1273 vaccine, considered as the second dose of his COVID - 19 vaccine schedule. No details of previous doses were provided. The patient had an arthroplasty and 50 days after surgery, in his postoperative control, he referred that after vaccination with mRNA  1273 he was malaise for several days and noticed an increase in his right shoulder pain, for which he needed narcotics as treatment. On an unspecified date the patient developed redness surrounding his incision, and in the examination an apparent central abscess was demonstrated. Fluid was aspirated and he was taken twice to the operating room for irrigation and debridement where it was noted purulence which disrupt 30% of the subscapularis repair. In the cultures taken from surgery C. acnes was developed, for which he was treated with an unspecified antibiotic (he completed 6 months of oral treatment). Patient´s medical history of type 2 diabetes mellitus and previous arthroplasty could be confounders confounder for postoperative abscess. The Benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.