Medical Case Reports

 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. Diag...

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 wi...

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...

A 50-year-old man visited a primary care clinic with persistent right arm pain and weakness lasting for 9 weeks. These symptoms began 5 days after receiving a mRNA COVID-19 booster vaccination in his right deltoid. The patient experienced a moderate-to-severe ache at the injection site, radiating to his neck. Over time, he developed progressive weakness in his right shoulder and elbow, along with occasional hand paresthesia.  Despite reporting his symptoms to Malaysian equivalent of VAERS database, the patient sought medical attention only after 9 weeks when his symptoms worsened to the point where he needed assistance with daily activities. He had no other symptoms or relevant medical history, except for completing two doses of an inactivated COVID-19 vaccine 7 months prior. Physical examination revealed muscle wasting in the affected areas without skin changes or tenderness. Neurological evaluations, including nerve conduction studies and electromyography, indicated axonal loss r...

Nobody is counting vaccine doses anymore. But COVID-19 is still here, remaining among the top five leading cause of death for older and immunocompromised individuals.  The national public health emergency in the US is set to end on May 11, 2023, with the last states to end statewide emergency orders being New Mexico on March 31 and Rhode Island on April 10, followed by Texas and Connecticut. However, recent events such as the CDC's April 24-27 Epidemic Intelligence Service conference in Atlanta have shown that the virus is still spreading. At least 35 people who attended the conference tested positive for COVID-19, as confirmed by spokesperson  Kristen Nordlund .  According to CDC, Atlanta has a low COVID-19 community level, along with nearly the rest of the U.S. In February,  Dr Deepti Gurdasani   reported her breakthrough case, despite six COVID-19 vaccine doses. Are these repeated doses even helping? There is some evidence they might be helping solid tra...

A 21-year-old non-smoking Caucasian male with a history of acute pancreatitis but no other medical issues or family history had two doses of the BNT162b2 mRNA COVID-19 vaccine.  Four months after the second dose he had his first episode of COVID-19. Although not hypoxic, he felt pretty unwell for a week, with a severe cough, fever, generalized body ache, headache, and loss of taste. He received the third dose of the vaccine two months after recovering from COVID. Nine months after the third dose, he had the second episode of COVID-19, during which he was mildly unwell for three days, recovered, and did not require any anti-viral medication or antibiotics. One week post the second episode of COVID-19, he developed diarrhea and abdominal pain. It then progressed to bloody diarrhea. Ulcerative colitis was diagnosed based on his clinical symptoms, biopsy changes, and the exclusion of other causes.  There are ten published case reports about the newly diagnosed ulcerative colitis ...

The frequency of CNS neuroinflammatory events reported in the literature after both SARS-CoV-2 infection and COVID-19 vaccination is still largely unknown. While these conditions can occur spontaneously, they have also been reported following vaccinations, including those for influenza, hepatitis B, human papillomavirus, and COVID-19. Viruses and their vaccines  may unmask   CNS neuroinflammatory conditions.   A 47-year-old man with a history of psoriasis and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection presented with 3 months of subacute lower extremity weakness, erectile dysfunction, and gait instability with falls. His symptoms started 2 weeks after receiving the second of his 2-shot primary mRNA vaccine series for coronavirus disease 2019 (COVID-19) vaccination, which he received 3 months after a mild case of COVID-19. He had no other relevant medical or family history and no recent travel. After evaluation by a urologist, he was prescribed ...