This literature marketed report as received from a other health professional refers to a 33 year old female patient with immunosuppressive therapy, and rheumatoid arthritis. This is case 5 of 5 reports. Patient's medical history was not reported. On an unknown date the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (manufacturer unknown) (dose and frequency unknown) in the arm. Other suspect therapies included influenza virus vaccine (manufacturer unknown). Both the vaccination were received in the same arm. Patient's concomitant medication was not reported. On an unknown date the patient experienced large local inflammatory reactions (erythema, oedema and warmth) (hospitalization), rigors (hospitalization), fever (hospitalization), leucocytosis (hospitalization) and presumed cellulitis (hospitalization). The patient's laboratory results included WBC 19.2K/microliter, ESR 71 mm/hr, Maximum temperature 101.8 degree F and CRP 14mg/dl. The patient was hospitalised and received antibiotics in hospital and post discharge from the hospital. The patient sought care within 2-3 d of vaccination and was admitted to the hospital for observation, with or without treatment of presumed cellulitis. The patient received full courses of antibiotics to cover for common skin flora as well as methicillin-resistant staphylococcus aureus. The patient received several different antibiotics due to worsening of the skin erythema despite aggressive intravenous antibiotic therapy. Within 5-7 days, the patient experienced improvement in the skin findings and resolution of the systemic symptoms. In one patient, the local swelling and erythema at the injection site lasted about 2 weeks. The outcome of large local inflammatory reactions (erythema, oedema and warmth) and presumed cellulitis was reported as recovering/resolving. The outcome of fever. This literature marketed report as received from a other health professional refers to a 43 year old female patient with asthma. This is case 4 of 5 reports. Patient's medical history was not reported. On an unknown date the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (manufacturer unknown) (dose and frequency unknown) in the arm. Other suspect therapy included influenza virus vaccine (manufacturer unknown). Both the vaccination were received in the same arm. The patient was also vaccinated with tetanus, diphtheria and acellular pertussis vaccine (Tdap). The patient received an additional injection Tdap vaccine in the opposite arm. On an unknown date the patient experienced large local inflammatory reactions (erythema, oedema and warmth), rigors, fever, leucocytosis and presumed cellulitis. The patient's laboratory results included WBC 22K/microliter, and Maximum temperature of 102.8 degree F. It was reported that the patient was not hospitalised. The patient sought care within 2-3 d of vaccination. Within 5-7 days, the patient experienced improvement in the skin findings and resolution of the systemic symptoms. In one patient, the local swelling and erythema at the injection site lasted about 2 weeks. No patients included in this series have received any subsequent vaccines. The outcome of large local inflammatory reactions (erythema, oedema and warmth) and presumed cellulitis was reported as recovering/resolving. The outcome of fever, leucocytosis and rigors was reported as recovered/resolved. The reporter considered the events to be not related to Influenza Virus Vaccine (manufacturer unknown). The reporter considered the events to be related to Pneumococcal Vaccine, Polyvalent (23-valent) (manufacturer unknown). The author stated that "the 5 patients in this series all had leukocytosis, fever and large local inflammatory reactions following influenza vaccine (manufacturer unknown) and Pneumococcal Vaccine, Polyvalent (23-valent) (manufacturer unknown). Based on the known side effects of Pneumococcal Vaccine, Polyvalent (23-valent) (manufacturer unknown), the lack of similar findings in patients who receive the influenza vaccine (manufacturer unknown) and the patient 2's lack of influenza vaccine (manufacturer unknown) associated local symptoms we believe these reactions were due to Pneumococcal Vaccine, Polyvalent (23-valent) (manufacturer unknown)". This case is linked to case # 1405USA008574, 1405USA007995, 1405USA008573 and 1405USA008576 (same reporter link). Additional information has been requested.