Showing posts from June, 2023

Delayed myocarditis following vaccination

 A healthy 24-year-old man with a history of allergic rhinitis experienced tightness in his chest, difficulty breathing, and coughing up blood six months after exposure to COVID-19 (he never tested positive nor experienced any symptoms) and three months after a second dose of the Moderna vaccine.  On arrival, his oxygen level was low, his heart rate was high, he had a fever, and his blood pressure was normal. He looked very sick and was sweating. Electrocardiography (ECG) showed sinus tachycardia with diffuse ST-segment elevation and T-wave inversion (Figure).   There were abnormal sounds in his lungs despite normal X-rays. His heart's electrical activity showed a fast rhythm with changes in the ST-segment and T-wave. Blood tests indicated heart damage and inflammation. An ultrasound of his heart showed that its pumping ability was reduced. A biopsy of his heart muscle confirmed inflammation Tests of fluid from his lungs showed no signs of bleeding or infection. Diagnosis was a del

New-onset acute psychosis post-vaccination and infection

A Case report published today describes new-onset acute psychosis as a manifestation of lupus cerebritis following concomitant COVID-19 infection and vaccination.  A 26-years old female with a family history of a mother diagnosed with schizophrenia, and no personal medical or psychiatric history, was diagnosed with mild COVID-19 infection four days after receiving the second dose of Pfizer-BioNTech COVID-19 vaccine.  She was asymptomatic when she received the COVID-19 vaccine. Two weeks later, she presented to the emergency department with chest pain, where physical examination revealed a heart rate of 110/min. A cardiac ultrasound examination showed a pericardial effusion suggestive of pericarditis. She was started on aspirin and colchicine, with a slow recovery. One month after receiving the vaccine, she presented to the psychiatric emergency department with acute psychomotor agitation, incoherent speech and total insomnia evolving for five days. She was firstly diagnosed with a brie

Reactivation of Epstein-Barr Virus Following COVID-19 Vaccination

Epstein-Barr virus (EBV) is a common human herpesvirus that infects a majority of adults worldwide, typically transmitted through saliva during childhood. While most EBV infections are asymptomatic or cause mild symptoms, it can lead to conditions such as infectious mononucleosis (IM) in adolescents and young adults. Here we present two cases suggesting a potential link between EBV reactivation and COVID-19 vaccination.  Case 1 : EBV-Associated Lymphoproliferative Disorder: A 79-year-old male presented with fever, pancytopenia, elevated liver enzyme levels, and other alarming laboratory findings two weeks after receiving the first dose of the BNT162b2 mRNA COVID-19 vaccine. Further investigations revealed EBV viremia localized in natural killer (NK) cells, suggesting a diagnosis of EBV-NK-LPD. Despite aggressive treatment attempts, the patient's condition worsened, and he succumbed to the disease two months later. Case 2 : Cutaneous Manifestations and EBV Reactivation: A 24-year-ol