Fatal Acute Disseminated Encephalomyelitis Post-COVID-19 Vaccination: A Rare Case Report

Nimkar, Shubham V; Yelne, Pallavi; Gaidhane, Shilpa; Kumar, Sunil; Acharya, Sourya; Gemnani, Rinkle R

doi:10.7759/cureus.31810

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…A systematic review has been identified (8) including 20 studies, out of which 19 were eligible to be included in our review: (9,10,(19)(20)(21)(22)(23)(24)(25)(26)(27)(11)(12)(13)(14)(15)(16)(17)(18) (Figure 1) In addition to the 19 studies included, our literature search has identified nine other studies: (28)(29)(30)(31)(32)(33)(34)(35). Thus, a total of 28 studies were analysed comprising a total of 38 cases.…”

Section: Resultsmentioning

confidence: 99%

The Heart vs. Brain, are They Also Different when it Comes to Post Vaccination Complications, Insights from a Systematic Review of Post-COVID-19 ADEM and Myopericarditis Cases

AbdelMassih¹,

Kamel²,

Mohammad³

et al. 2023

Preprint

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Background: COVID-19 vaccines have been a game changer in the pandemic, their extensive use was favorable compared to the burden of COVID-19 complications. Despite the low incidence of complications, it was important to analyze them carefully to understand the underlying mechanisms and predisposing factors. For instance, myopericarditis especially from mRNA vaccines, and its relatively higher prevalence in young adults and adolescents has raised a public concern about the use of this vaccine in this group. We aimed through this review to compare the age likelihood of ADEM from COVID-19 vaccines, with that reported in myopericarditis cases; secondary outcome parameters included the gender and number of doses needed to induce COVID-19 vaccines related ADEM. Methodology: A literature search has been conducted on relevant databases to retrieve all case reports/series and systematic reviews describing ADEM with possible linkage to COVID-19. Exclusion criteria included any report not including the desired outcome parameters. Our results were then qualitatively compared with a similar systematic review reporting myopericarditis from COVID-19 vaccines. Results: In 38 cases with ADEM, mean age was 49±16 compared to 25±14 in myopericarditis, females were more likely to be affected, and while most of myopericarditis cases develop after the second dose, most of ADEM cases develop after the first dose (76%). Moreover, age>56 years was more predictive of negative outcome after ADEM in the form of death or permanent vegetative state. Conclusion: The discrepancy in age, gender and number of doses needed to induce complications between ADEM and myopericarditis, signify that the tissue affected is the major orchestrator of the age, gender, and dose characteristics, and not the type of vaccines. A leakier blood brain barrier with aging, might allow easier passage of autoantibodies and cytokines into the brain while lack of inhibitory immune checkpoints in the myocardium in young age might explain the higher prevalence of those cases in young adults and adolescents.

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Section: Resultsmentioning

confidence: 99%

The Heart vs. Brain, are They Also Different when it Comes to Post Vaccination Complications, Insights from a Systematic Review of Post-COVID-19 ADEM and Myopericarditis Cases

AbdelMassih¹,

Kamel²,

Mohammad³

et al. 2023

Preprint

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“…We hypothesize that this bacterium may be a component of the microbiota inhabiting the gastrointestinal tract given that the bulk of S. fonticola isolates in our medical system originated from urine cultures (Nimkar et al, 2022). The two instances of polymicrobial bacteraemia in individuals who had intestinal mucosal damage (Lin et al, 2010) provide evidence for this.…”

Section: Discussionmentioning

confidence: 96%

Serratia fonticola causing acute meningoencephalitis in a young male: A first case report

Patel¹,

Kumar²,

Acharya³

et al. 2023

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Serratia fonticola infections are less common in human beings. The few cases that have been documented mainly speak of infections of the heart, skin, soft tissues, urinary and biliary tracts. Here is the case of a 20-year-old man who brought with altered sensorium, 2 episodes of seizures and high-grade fever due to Serratia fonticola-induced meningoencephalitis infection, which was confirmed with cerebrospinal fluid examination and culture report. The patient had no prior history of recurrent urinary tract infection or fever. The patient received 3 weeks of antibiotic and steroid treatment and recovery went smoothly. Using PubMed and Google Scholar, we conducted a thorough review of the literature and came to the conclusion that this is the first case of meningoencephalitis caused by S fonticola that has been documented.

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“…When a thorough workup fails to identify an underlying cause, a case is classified as idiopathic transverse myelitis. Secondary causes of disease-related transverse myelitis include infections, connective tissue disorders, vitamin B12 deficiency, recent vaccinations, and multiple sclerosis [ 5 ]. While hematological features are the primary presentation of copper deficiency, copper deficiency myelopathy (CDM) is a typical presentation in all cases of neurological manifestations of copper insufficiency [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Postpartum Hypocupric Myelopathy Masquerading as Acute Transverse Myelitis: A Case Report and Literature Review of a Rare Presentation

Pantbalekundri,

Kumar,

Acharya

et al. 2024

Cureus

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The symptoms of transverse myelitis, an acute demyelinating inflammatory condition of the spinal cord, include motor, sensory, and bowel-bladder dysfunction that can develop suddenly or gradually. Several etiologies, such as bacterial, fungal, or viral infections, cancer, autoimmune diseases, vascular problems, and environmental variables, can cause it. The identification of copper deficiency myelopathy (CDM) as a curable cause of non-compressive inflammatory myelopathy has only occurred recently. Patients frequently present with sensory complaints and a spastic gait. The neurological disease may exist independently of the hematologic signs. Only a few cases of copper myelopathy in peripartum women have been documented. Given that hypocupric myelopathy is a treatable cause of debilitating paraplegia, maintaining clinical vigilance will be crucial in minimizing neurological sequelae, as demonstrated in this case report.

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Fatal Acute Disseminated Encephalomyelitis Post-COVID-19 Vaccination: A Rare Case Report

Cited by 6 publications

References 12 publications

The Heart vs. Brain, are They Also Different when it Comes to Post Vaccination Complications, Insights from a Systematic Review of Post-COVID-19 ADEM and Myopericarditis Cases

The Heart vs. Brain, are They Also Different when it Comes to Post Vaccination Complications, Insights from a Systematic Review of Post-COVID-19 ADEM and Myopericarditis Cases

Serratia fonticola causing acute meningoencephalitis in a young male: A first case report

Postpartum Hypocupric Myelopathy Masquerading as Acute Transverse Myelitis: A Case Report and Literature Review of a Rare Presentation

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