Necrotizing fasciitis following measles vaccine administration: a case report

Abstract

Background The occurrence of adverse events following immunization (AEFI) in national immunization programmes is very rare; however, if they occur causality assessment is conducted to identify the associated cause. In the report, we describe a case of severe necrotizing fasciitis in the left arm of a 9-month old boy following administration of the measles vaccine. Case presentation A 9-month old boy presented with swelling on the left upper arm and adjoining the chest area, low-grade continuous fever, frequent passage of loose watery stool and persistent cries 24 h after measles vaccine was administered on the left upper arm. On examination, he was mildly pale, febrile, anicteric. Extensive erythema of the left upper arm occurred thereafter with extensive scalded skin lesions involving the deltoid area, the upper chest wall and arm. This was followed by desquamation of the affected areas and severe necrosis. A diagnosis of severe necrotizing fasciitis was made. A causality assessment was conducted by the state AEFI committee using the detailed AEFI investigation forms to identify the cause of the incidence. Conclusion Here we present a rare case of necrotizing fasciitis which could have been caused by incorrect use of reconstituted measles vaccine. Hence we recommend training of routine immunization service providers on proper vaccine management as well as intensified supervision of immunization sessions.

Necrotizing Soft Tissue Infection: A Single-Center Retrospective Study of Treatment and Outcomes

“…Necrotizing fasciitis (NF) infections are rare and severe soft tissue infections characterized by rapid, progressive spreading among deep and superficial fascia and subcutaneous tissue, which can lead to shock and sepsis with multiorgan failure and a potentially fatal outcome [1]. Initial symptoms are tissue swelling, erythema, crepitations, fever, tenderness, odor, pain, bullous changes, and skin necrosis [2][3]. At first, the patient may be presented with cellulitis because of the similarity with NF, which then rapidly progresses with pain disproportionate to the area of infection.…”

“…Initial symptoms are tissue swelling, erythema, crepitations, fever, tenderness, odor, pain, bullous changes, and skin necrosis [ 2 - 3 ]. At first, the patient may be presented with cellulitis because of the similarity with NF, which then rapidly progresses with pain disproportionate to the area of infection.…”

Local myofascitis of the deltoid muscle after administration of the AstraZeneca (AZD1222) COVID-19 vaccine: two cases, infectious and inflammatory

“…In general, locally occurring fascitis is mainly caused by the local injection of drugs, and necrotizing fascitis[ 11 , 20 ], eosinophilic fascitis[ 19 ], and macrophagic myofascitis have been reported for various drugs. To date, the most well-known myofascitis occurring after vaccination is macrophagic myofascitis (MMF).…”

“…[ 6 , 9 ] However, the COVID-19 vaccines developed so far do not contain adjuvants to enhance the effectiveness of the vaccine. Cases of necrotizing fascitis after administration of the measles vaccine have been reported previously[ 11 ], as has local myofascitis after deep subcutaneous injections of somatostatin analogs in patients with acromegalo-gigantism. [ 10 ]…”

Necrotizing fasciitis pediatric debut

“…A diferencia de los adultos, que suelen estar condicionados por una situación de inmunodepresión, la FN ocurre con mayor frecuencia en niños sanos. Los eventos predisponentes comúnmente reconocidos incluyen cirugía, traumatismo, ampollas de varicela rotas e inyección intramuscular [ 6 ].…”