Medical Case Reports

A 14-year-old Japanese girl died unexpectedly 2 days after receiving the third dose of the BNT1262b2 mRNA COVID-19 vaccine. Autopsy findings showed congestive edema of the lungs, T-cell lymphocytic and macrophage infiltration in the lungs, pericardium, and myocardium of the left atria and left ventricle, liver, kidneys, stomach, duodenum, bladder, and diaphragm. Since there was no preceding infection, allergy, or drug toxicity exposure, the patient was diagnosed with post-vaccination pneumonia, myopericarditis, hepatitis, nephritis, gastroenteritis, cystitis, and myositis. Arrhythmia of atrial origin was assumed as the cause of cardiac failure and death.  Histopathology of the heart (left atrium), lung, liver, kidney, diaphragm, stomach, duodenum, and bladder of the child (Figure) show severe infiltration.  Multisystem inflammatory syndrome is a life-threatening condition associated with elevated inflammatory markers and multiple organ injury. A diagnosis of exclusion, it has...

Two more cases of hepatitis/colitis and hepatitis/MIS-C to add to the  January post .  New report describes a case similar to previously published  case reports of hepatitis after COVID-19 vaccination.  This article reports a case of hepatitis and colitis in a 52-year-old woman who was undergoing immunotherapy and was HBV positive 10 days after receiving the first Pfizer-BioNTech COVID-19 vaccine dose. Because both ICIs and the COVID-19 vaccines stimulate the immune response, the authors hypothesized that these vaccines may increase the incidence of irAEs during ICI treatment. There is a complex interplay between the immune-mediated reaction triggered by the vaccination and PD-L1 co-administration. Another case describes a 17-year-old female hospitalized for a history of fever, asthenia, cough, anorexia, abdominal pain, and vomiting. The patient has a positive familial history for autoimmune disorders (inflammatory bowel diseases, connective tissue diseases, and m...

  Previously healthy young adult experienced mild case of COVID-19 and got vaccinated on the 6th day of symptom onset. 20 days later he received his second dose of the vaccine that caused fatigue and malaise resolved within 2 days. 22 days later he had onset of new fever, malaise, headache, and odynophagia, developed tachycardia,  thrombocytopenia and eventually died from  severe multisystem organ failure despite treatment.   Fatal Multisystem Inflammatory Syndrome in Adult after SARS-CoV-2 Natural Infection and COVID-19 Vaccination Abstract We describe a fatal case of multisystem inflammatory syndrome in an adult with onset 22 days after a second dose of mRNA coronavirus disease vaccine. Serologic and clinical findings indicated severe acute respiratory syndrome coronavirus 2 infection occurred before vaccination. The immunopathology of this syndrome, regardless of vaccination status, remains poorly understood. Grome HN, Threlkeld M, Threlkeld S, Newman C, Mar...