Yellow Fever Vaccine-Associated Neurotropic Disease: A Case Report Of A 9-Month Old Infant And Review Of Literature

Abstract

Introduction

Yellow fever vaccine-associated neurotropic disease (YEL-AND) is a rare and serious complication following vaccination with the 17D live attenuated yellow fever vaccine. Cases of YEL-AND present as acute inflammatory demyelinating polyneuropathy, acute disseminated encephalomyelitis, and meningoencephalitis and encephalitis. To date, only a few cases have been reported in the literature in children.

Methods/Subject

We present the case of a 9-month-old male who developed YEL-AND. He suffered "3 episodes of unprovoked generalized tonicclonic seizure," the first occurring within 2 hours of receiving a dose of the Yellow Fever vaccine, Measles, and Meningococcal vaccines. He was lethargic for 28 hours and had intermittent inconsolable cries for 48 hours, low-grade fever, and loss of motor milestones (sitting and standing). Available laboratory investigations and neuroimaging ruled out other possible causes. He was treated with anticonvulsants and IV Methylprednisolone and made a significant recovery and was discharged on the sixth day and has remained stable on follow-up. His clinical presentation, neuroimaging, and challenges in his management are discussed in this case report.

Conclusion

The licensed Yellow fever vaccines are safe, effective for the prevention of Yellow fever, and highly recommended, however, it is not completely devoid of serious adverse reactions. This case highlights a possibility of a very early onset of YEL-AND in children and should be suspected in individuals with a temporal relationship of symptom onset to vaccination.