Medical Case Reports

In early January 2023, it become known that the CDC's near real-time surveillance system (the Vaccine Safety Datalink containing health records of more than 12 million Americans) detected a possible increase in ischemic stroke in people 65 and older who recently got one of Pfizer’s ( BioNTech)  updated  booster shots.  It found that 130 seniors had the stroke within 21 days of the shot ( compared with days 22-44 following vaccination ).  This 'met the statistical criteria to prompt additional investigation', the CDC statement said.  CDC officials used an alternative methodology to conduct a different analysis in the VSD database but could not replicate the finding.  They also checked the Center for Medicare and Medicaid Services system, containing 83.9 million individuals, and the Veterans Affairs database, with nine million people. Neither dataset indicated an increased risk of ischemic stroke following a bivalent vaccine.  A large study of updated (...

A six-and-a-half-year-old fully vaccinated and previously healthy Asian boy presented to the accident and emergency department with 5-day history of high-grade fever associated with non-projectile vomiting, loose stools, abdominal pain, generalized rashes and conjunctivitis without discharge, reduced oral intake and urine frequency. However, he had no history of cough, joint or limb pain, sore throat or rhinorrhea. He was treated for a suspected bacterial infection with co-amoxiclav and paracetamol then cefixime, ibuprofen and desloratadine. As the illness progressed , he became extremely weak associated with headache and on the day of presentation at the hospital he was irritable, had lost speech with mouth deviation towards the left side. He had no reported convulsions, visual disturbance, difficulty swallowing, drooling, difficulty breathing or incontinence. A week prior to his illness, he was exposed to a relative suffering from COVID-19.  A brain MRI revealed acute ischemic in...

A previously healthy woman in her 60s had mild fever and uneventful course after the 1st dose of  ChAdOx1 nCoV-19 vaccine, but  developed behavioral problems and refusal to take food, one day after receiving the second dose of ChAdOx1 nCoV-19 vaccination (dose interval 84 days). Her condition progressed rapidly with onset of confusion, forgetfulness, and hallucinations within the next 5 days. Over the next two days, the patient developed difficulty in walking and echolalia. She was prescribed amantadine, trihexyphenidyl and clonazepam by a local practitioner but she showed further deterioration in the form of irritability, incoherent speech, aggravated forgetfulness, auditory and visual hallucinations, abnormal movements of limbs, and jaw and neck dystonia. The patient had a serum anti-Spike protein IgG titer of 1891.5 AU/mL (non-reactive<50 AU/mL) at 37 days post-second dose. An initial magnetic resonance imaging (MRI) of the brain had revealed FLAIR hyperintensity in bila...

38-year-old woman  without systemic disease presented with acute-onset amnesia, language disturbance, and seizure two weeks after the first dose of ChAdOx1 nCov-19 vaccine. Brain magnetic resonance imaging revealed a subacute infarction at the right internal capsule and irregular vascular contour, which indicated a vasculopathy. Cerebrospinal fluid analysis revealed inflammation without pleocytosis, and electroencephalography detected diffuse background slowing with sharp transients at the right temporal region.   Although autoantibody tests were negative, steroid pulse therapy was initiated. The patient's symptoms improved rapidly. The patient was discharged without neurological deficit or sequelae. One week after discharge, the patient received repeat EEG, which revealed resolved slow waves without epileptiform discharges. Three months later, repeated brain MRI revealed regressive change of previous irregularity of vascular contour. (Fig. C)  Cases of post-vaccinal...

We observed cases of transient global amnesia (TGA) after the 1st or 3rd dose of a COVID-19 vaccine in the elderly population of our study .   Recent review of  reports from the World Health Organization VigiBase ®  ideitified 289 TGA cases associated with a COVID-19 vaccine.  The  Pfizer-BioNTech COVID-19 Vaccine, also known as COMIRNATY® or  Tozinameran was mostly represented (147, 50.8%), followed by t he Oxford/AstraZeneca or ChAdOx1-S AZD1222 (69, 23,8%), Moderna -  SPIKEVAX,  elasomeran - (60, 20.8%), and JNJ-78436735 (12, 4.2%).  Cerebrovascular, inflammatory, or migrainous mechanisms may underlie this association. Yet, numerous confounding factors cannot be tackled with this approach, and causality cannot be ascertained.  Here is an exemplar medical case : Two weeks after receiving the first dose of ChAdOx1 nCov-19 vaccine, a disease-free 38-year-old woman experienced acute onset of abnormal symptoms, such as amnesia, incoh...

A 67-year-old fully vaccinated and boosted man with Down syndrome (DS) died early February 2022 after he contracted COVID-19. The man spent 12 says in the hospital  and an intensive care unit due to his underlying health  conditions but was brought home and was cared by his family for the last 6 days preceding his death. The  man suffered a stroke 17 years ago.  Individuals with Down syndrome are presumed to be at high risk of severe CoVID-19, due to immune dysregulation and often compromised cardiopulmonary function. DS is caused by the presence of full or partial extra copy of chromosome 21 ( HSA21 ). REFERENCES The Austin American-Statesman, the major daily newspaper for Austin, the capital city of Texas: https://www.statesman.com/story/news/2021/12/21/donor-pays-off-loan-statesman-season-caring-austin-palliative-care-family/8962545002/ https://www.statesman.com/in-depth/news/2021/11/24/austins-judy-silva-brother-down-syndrome-season-for-caring/625450800...

A 64-year-old lady with long standing history of migraine and recently diagnosed hypertension on amlodipine, presented with history of continuous excruciating headache and vomiting of 10 days duration. Five days after onset of headache, she developed drowsiness and difficulty in walking. She had received two doses of COVISHIELD (AstraZeneca, ChAdOx1) vaccine, 2 months back. On examination, patient had  significant vision impairment  in both eyes with normal pupillary reflexes,  quadriplegia  and recurring focal seizures involving right upper limb. She tested positive for SARS-CoV-2. Repeat  MR angiogram showed widespread vasoconstriction of intracranial blood vessels suggestive of Reversible Cerebral Vasoconstriction Syndrome (RCVS).  CSF analysis was normal. Although patient was diagnosed with COVID 19, patient did not complain of cough, breathlessness or fever. Oxygen saturation  in room air was 92% and CT chest showed m...

An 18-year-old woman started experiencing symptoms 9 days after vaccination.  She checked into the emergency room complaining of severe headaches and extreme light sensitivity. A CT scan and neurological tests found nothing, so doctors discharged her and recommended to return in 15 days for further tests. But she returned to the hospital just two days later. She now suffered from paralysis in at least one part of her body. This time she was diagnosed with  cavernous sinus thrombosis , meaning a blood clot in the space between the eye sockets and brain. It blocked the primary vein between her head and the heart. Doctors also discovered that she had a brain bleed . She underwent two surgeries, one to remove the blood clot and the second to relieve pressure in her head caused by the bleeding. But the damage was done.  She died 5 days later,  She was previously healthy and was not taking any medications.  REFERENCES Camilla, who died at the age of 18 after AstraZene...

  A 60-year-old woman with medical history notable for type II diabetes, hypertension, atrial fibrillation and systemic lupus erythrematosis  presented on May 2, 2021 with a one-week history of fever (T max  104 F) and productive cough. Notably, the patient had been vaccinated with an mRNA vaccine (Pfizer, New York, NY) receiving the second dose on February 18, 2021. She underwent routine COVID testing in anticipation of screening colonoscopy procedure and tested positive on April 1, 2021.  The patient was negative for SARS-CoV-2 antibodies upon hospital admission on May 3, 2021.   The patient was admitted to the ICU due to acute hypoxic respiratory failure on May 9, 2021. She had a complex course which included treatment with broad spectrum antibiotics given her immunocompromised state, high dose steroids for concern for lupus flair, and remdesivir .  Hypoxic respiratory failure, complicated by disseminated intravascular coagulopathy (dissem...

Previously healthy woman in her thirties develops headaches one week after vaccination with ChAdOx1 nCoV-19, is admitted in the emergency department with slurred speech, uncoordinated movements and reduced consciousness, dies from thrombocytopenia. Post mortem examination reveals antibodies to PF4 and fresh small thrombii the transverse sinus, frontal lobe and pulmonary artery. Fatal cerebral haemorrhage after COVID-19 vaccine Tor Halvor Bjørnstad-Tuveng ,  Anders Rudjord ,  Peder Anker PMID:  33928772   DOI:  10.4045/tidsskr.21.0312 Read more