Medical Case Reports

Severe post-vaccinal complications could be driven by an overactive immune response. In a new case series , recently published in Cureus, three rheumatic disease patients with low disease activity needed hospitalization and new biological treatments, and one patient died after her 4th dose of SARS-CoV-2 mRNA vaccine. Cytokine analysis showed elevated levels of IL-1β, IL-6, IL-17, and TNF-α, indicating a cytokine storm, possibly triggered by IL-6 amplification (IL-6 Amp). This mechanism involves excessive IL-6 production through a feedback loop activated by simultaneous stimulation of NF-κB and STAT3 pathways Case 1: Acute Exacerbation of Interstitial Pneumonia in an 80-Year-Old Woman An 80-year-old woman with a history of rheumatoid arthritis (RA) had been in remission for five years thanks to a regimen including subcutaneous tocilizumab (TCZ-SC) and tacrolimus. However, after receiving the Pfizer-BioNTech vaccine, she developed severe dyspnea requiring oxygen. Her CT scan revealed new...

Encephalitis is an inflammatory condition affecting the brain, characterized by the swelling of the brain tissue. This inflammation is often triggered by viral infections, although it can also result from bacterial infections, autoimmune disorders, or vaccination.  Multiple cases have been presented in the literature.  Anti NMDA Autoimmune Encephalitis in a Pediatric Patient: Anti-NMDA receptor encephalitis is a rare autoimmune disorder that affects the central nervous system. In this condition, the body's immune system mistakenly targets and attacks NMDA receptors in the brain. NMDA receptors are essential for normal brain function, and their dysfunction can lead to a range of neurological symptoms. The condition is often associated with the presence of antibodies against the NMDA receptors. The case involves a 13-year-old female who developed anti-NMDA autoimmune encephalitis after receiving the Pfizer–BioNTech COVID-19 vaccine. The patient presented with subacute neurologic...

A recent study found significant destruction in ribosomal RNA structures after vaccination, a phenomenon that was enhanced by serial shots. This destruction led to massive inhibition of translation and transcription, affecting intra/inter neural signaling transfer and lipid metabolism. These processes are related to the aging process, and the destruction was identified even six months after vaccination. The cases described in cited papers include: 82-year-old female with colorectal cancer in remission: Complications of vaccination: abdominal pain, appetite loss, constipation, anemia, anorexia. Cancer relapsed after vaccination, leading to her death (patient 6 in Tanaka et al, 2022 : Archives of Clinical and Biomedical Research) 85-year-old female with esophageal cancer in remission: Complications of vaccination: dysphasia.  Cancer relapsed after vaccination, along with suspected microembolus in the brain, causing symptoms of memory loss, hoarseness, and dysphagia, leading to her de...

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...

People continue to die from COVID-19 despite vaccinations, particularly if they are elderly and in the presence of comorbidities. An 83-year-old fully vaccinated man (Pfizer vaccine) who suffered from heart failure, valvular heart disease, chronic obstructive pulmonary disease (COPD), diabetes mellitus, and chronic renal failure, was admitted to hospital with worsening dyspnea as an exacerbation of chronic heart failure. A nasopharyngeal swab tested negative for SARS-CoV-2 on admission to the hospital. After 11 days of hospitalization, the patient complained of worsening dyspnea, the health workers again took a molecular swab that gave a positive result for COVID-19. Although the patient was treated for COVID-19 according to the guidelines, he died after 18 days.  The autopsy was conducted according to the Letulle technique, thus reducing environmental contamination. On microscopic examination, the lungs showed massive interstitial pneumonia, areas of inflammation with interst...

K er ato ac anth omas are a type of skin growth that can be found in people of any age or gender but are more common in older individuals. They are characterized by a raised , round , or dome - shaped les ion that is typically filled with a thick , yellow ish - brown crust y material . Ker ato ac anth omas are typically caused by sun exposure , chemical carcinogens , cancer drugs such as vemurafenib and diabrafenib, recent injury to the skin, and other factors such as genetics and hormonal changes . Human papilloma virus (HPV) has been also suggested as a causal factor. A new case report published in JMIR Dermatology describes a novel case of a healthy 86-year-old man who experienced an eruption of multiple keratoacanthomas 2 weeks after vaccination with the Moderna mRNA-1273 vaccine. 12 days after his second dose of the vaccine, he began to experience severe pruritus of the lower pretibial area, and within 2 days, he noticed red no...

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a  rare disease with an annual incidence of approximately 20 per million population in Europe and North America. The aetiopathogenesis is complex and is mainly driven by the gene environment interactions. Genes associated with this condition include HLA-DQ (variations in which have been linked to asymptomatic COVID), IL-5 and GPA33. COVID-19 heralds a poor prognosis in those with preexisting AAV with over 50% patients having severe disease. Loss of smell is observed in AAV population more frequently (~50%) than in others (~35%).  70-year-old Chinese woman presented  with poor appetite and nausea 4 hours after receiving the first dose of CoronaVac vaccine. These symptoms progressively worsened, followed by fatigue and foamy urine 10 days later. Her medical history included hypertension, hyperlipidemia, and kidney stones. She had penicillin allergy and no family history of ANCA-associated vasculitis...

  An 85-year-old Japanese woman with chronic renal failure and hypertension  developed malaise, vomiting, and persistent high fever (up to 39.7°C) on the 12 th  day after receiving the second dose of the  BNT162b2  vaccine. Initial evaluation revealed neutropenia.  Further tests showed hyperferritinemia (serum ferritin 2284.4 μg/L). Bone marrow examination revealed haemophagocytosis. A provisional diagnosis of HLH associated with the Comirnaty ®  vaccination was made based on the HLH-2004 diagnostic criteria.  The patient was treated with granulocyte colony-stimulating factor and 500 mg methylprednisolone. A significant improvement was observed; the abnormal laboratory results resolved gradually, and the patient was discharged. READ MORE REFERENCE Shimada Y, Nagaba Y, Okawa H, Ehara K, Okada S, Yokomori H. A case of hemophagocytic lymphohistiocytosis after BNT162b2 COVID-19 (Comirnaty®) vaccination. Medicine (Baltimore). 2022 Oct 28;101(43):e3130...

A 75-year-old African American woman presented to the Emergency Department (ED) complaining of shortness of breath, cough and a drop in her oxygen saturation (SpO2) from her baseline of 95%–88%.  She received a Pfizer COVID 19 booster vaccine one day before her symptoms began. The patient had received the Johnson & Johnson COVID-19 vaccine 11 months prior without a notable reaction.    She had a history of  chronic obstructive pulmonary disease (COPD)  but was  not on any home oxygen.  Upon admission the patient had an SpO2 of 82% and a heart rate of 101 beats per minute. Notably, she was afebrile, with a temperature of 36.6 °C. On physical exam the patient was noted to be wheezing and breathing with difficulty. She t ested negative for a variety of respiratory viruses including COVID-19.  A chest radiograph (x-ray) demonstrated subtle patchy opacifications consistent  with a COPD exacerbation, and no consolidations or pleural effusions....

An 86-year-old male was transported to the Emergency Department of a hospital after a syncopal episode associated with abdominal pain and diarrhea. He had multiple comorbidities ( ischemic heart disease, diabetes, hypertension ) and received two doses of BNT162b2 (Pfizer-BioNTech) mRNA vaccination (the last dose seven months before admission) and was fully vaccinated since the 3rd dose was not yet recommended.  Laboratory tests at admission showed modest increase in C reactive protein  and creatinine.  CT documented two faint areas of ground glass opacity (GGO) in the left lower lobe and oropharyngeal swab tested positive for SARS-CoV-2 infection.  Despite the appropriate treatment, the clinical condition of the patient did not improve, leading to his death about three weeks after the hospital admission. Post-mortem CT (PMCT)  also known as virtual autopsy is a non-invasive imaging autopsy appropriate for COVID-19 cases  due to biohazard challenges. PMCT...

79-year old female, resident of a retirement home in Maple Ridge of British Columbia    with history of  chronic obstructive pulmonary disease, emphysema and diabetes   received a Moderna vaccine. Ten minutes later, she was having a hard time breathing. Soon she was unconscious. A nurse administered two EpiPens – one in a leg, and one in an arm, but they couldn’t save her.  She was gone in 15 minutes.  It had been a severe anaphylactic shock, despite the fact that she had never had an allergic reaction in the past.  Her daughter is  one of the first people in Canada to be compensated for a family member’s death under Canada’s Vaccine Injury Support Program.  The program started in June of 2021. So far it has 774 claims, eight claims have been already approved by the program’s medical review board. REFERENCES https://www.mapleridgenews.com/news/maple-ridge-woman-compensated-for-mothers-death-from-covid-19-vaccine/ https://canadatoday.news/bc/m...

A 45-year-old male was extremely reluctant to be vaccinated but was pressured at his workplace. The patient's unusual behavior began within five days of receiving the one-dose Ad26.COV2.S adenoviral vector vaccine. He became anxious, suspicious, paranoid, disorganized and complained of headaches. No neurological deficits were found upon examination. Two weeks after the COVID-19 vaccination, persecutory delusions and delusions of reference led the patient to suicide attempt by stabbing himself in the abdomen. After abdominal surgery, the patient was admitted to the Clinic of Psychiatry. In addition to paranoid delusions, the psychiatric evaluation revealed intrapsychic tension and low affect modulation. After two weeks of treatment, the patient's condition improved. After 23 days of treatment in the Clinic, he was discharged without psychotic symptoms.    A 41-year-old male patient developed anxiety during the COVID-19 pandemic. Five days after the second dose of ...

COVID-19 vaccine-related pneumonitis (CV-P) should be considered in  patients with atypical lung infiltration, no specific etiologies, and recent  COVID-19  vaccination.  An article posted ahead of print by the Korean Journal of Internal Medicine describes 11 cases with a median age of 80. 10 individuals survived, but one patient with acute respiratory distress syndrome (ARDS), an 82-year-old-female, died despite appropriate treatment. Her chest CT displayed diffuse alveolar damage (DAD pattern).  Here are several other cases: An 83-year-old woman who received the second dose of BNT162b2-mRNA vaccine presented with an organizing pneumonia pattern of CV-P. Chest CT revealed multifocal patchy consolidations, ground-glass opacifications (GGOs), and mild interlobar septal thickening in both lungs (14 days after the second dose). BAL fluid analysis revealed neutrophils (Np) 24%, lymphocytes (Lp) 32%, eosinophils (Eo) 32%, and macrophages (Mq) 12%. All microbiolo...

For 60 years, a dozen of high-income countries provides some form of compensation for injuries and deaths following vaccination.  The injury support programs worldwide are starting to pay the victims of COVID-19 vaccines.  A 91-year-old Japanese woman died  from an acute allergic reaction and acute myocardial infarction after getting vaccinated. She h ad underlying conditions, including a cerebral ischemic attack and hypertension, which could have been related to her death.  An expert subcommittee of the health ministry assessing the health damage caused by COVID-19 vaccinations approved the payment for her family on July 25, 2022. Nine cases have been screened for eligibility for lump-sum death benefits after receiving a COVID-19 shot. Eight cases have been put on hold, and this is the first time the relief system was applied to a post-COVID-19 vaccination death. REFERENCES Payout for post-vaccination death approved for 1st time | The Asahi Shimbun: Breaking Ne...

A centenarian who had survived a hundred years of ups and downs of life died from breakthrough COVID-18 on Saturday, June 25th , 2022 .  He was suffering from multiple ailments like renal issues,  blood pressure, diabetes and was admitted to a private hospital where he tested positive for the virus. He was on liquid diet as was not able to eat properly. He died 7 days later.  Neither of his family members tested positive for SARS-Cov-2 The individual was vaccinated with two doses of Covaxin  -  also known as BBV152, a whole inactivated virus-based COVID-19 vaccine developed by Bharat Biotech in collaboration with the Indian Council of Medical Research - National Institute of Virology.  Currently India is experiencing the fourth wave of COVID-19 dominated by BA.2.75 (dubbed " Centaurus ", BA.5 and BA.4 A  very early analysis  of data from India by Raj Rajnarayanan indicates that BA.2.75 may have a growth advantage over BA.5. It is unclear, as yet...

COVID-19 vaccines reduce hospitalization and death, but they don't completely eliminate it. Why are not we studying the fatal cases, to help those not protected by the existing vaccines? Latest report from Public Health Ontario mentions 24 individuals 70 years of age and older that died from COVID-19 despite receiving 4 doses of COVID-19 vaccines. Yes, this is a much smaller number compared to the number of people who died after 3 doses, but since many vulnerable individuals  have already died from COVID-19 and many of vaccine-sensitive/virus vulnerable persons were not able to get additional shots, isn't it time to look into this instead of keeping increasing the number of mandated doses?  REFERENCE ENHANCED EPIDEMIOLOGICAL SUMMARY Confirmed Cases of COVID-19 Following Vaccination in Ontario: December 14, 2020 to March 27, 2022

We discuss 29 cases with a median age 82.  A   78-year-old man went to the Emergency Department at King Fahad Medical City in Riyadh, Saudi Arabia, with numerous bullae throughout his extremities one day after receiving the second dose of Pfizer Covid-19 vaccine. The bullae were preceded by intense pruritus and urticated plaques. A  skin biopsy  was performed which revealed IgG (+1), IgM (+1), and C3 (+1) staining of the  basement membrane . The patient was treated with topical and systemic corticosteroids, fusidic acid  cream, and emollients after a confirmed diagnosis of bullous pemphigoid (BP) was obtained. He was hospitalized for 3 weeks as a case of severe sepsis due to a skin infection, and he was started initially on empiric antibiotics with piperacillin-tazobactam plus vancomycin that was later upgraded to  meropenem  and vancomycin based on the results of the blood and wound cultures. The patient suffered a  pulmonary...