TY - JOUR
T1 - A 4-month-old baby presenting with dermal necrotizing granulomatous giant cell reaction at the injection site of 13-valent pneumococcal conjugate vaccine
T2 - A case report
AU - Alsuwaidi, Ahmed R.
AU - Albawardi, Alia
AU - Khan, Navidul Haq
AU - Souid, Abdul Kader
N1 - Publisher Copyright:
© 2014Alsuwaidi et al.; licensee BioMed Central Ltd.
PY - 2014/8/24
Y1 - 2014/8/24
N2 - Introduction. Adjuvants (for example, aluminum salts) are frequently incorporated in licensed vaccines to enhance the host immune response. Such vaccines include the pneumococcal conjugate, combinations of diphtheria-tetanus/acellular pertussis, tetanus- diphtheria/acellular pertussis, hepatitis B, some Haemophilus influenzae type b, hepatitis A, and human papillomavirus. These preparations have been associated with complicated local adverse events, especially if administered subcutaneously or intradermally in comparison to deep intramuscular injection. We describe a severe inflammatory reaction at the site of an injection of 13-valent pneumococcal conjugate vaccine.Case presentation. A 4-month-old Arab baby boy developed dermal necrotizing granulomatous giant cell reaction at the injection site (right anterior thigh) of the second dose of 13-valent pneumococcal conjugate vaccine. Ziehl-Neelsen and periodic-acid Schiff were negative. This reaction probably resulted from improper intramuscular administration because the first (at 2 months of age) and third (at 10 months of age) doses were uneventful.Conclusions: Dermal necrotizing granulomatous reactions are a serious complication of the 13-valent pneumococcal conjugate vaccine. Health care providers need to administer this preparation deeply into a muscle mass. Completing the vaccine series is an acceptable option. Physicians are encouraged to report their experience with completing vaccine series following adverse events.
AB - Introduction. Adjuvants (for example, aluminum salts) are frequently incorporated in licensed vaccines to enhance the host immune response. Such vaccines include the pneumococcal conjugate, combinations of diphtheria-tetanus/acellular pertussis, tetanus- diphtheria/acellular pertussis, hepatitis B, some Haemophilus influenzae type b, hepatitis A, and human papillomavirus. These preparations have been associated with complicated local adverse events, especially if administered subcutaneously or intradermally in comparison to deep intramuscular injection. We describe a severe inflammatory reaction at the site of an injection of 13-valent pneumococcal conjugate vaccine.Case presentation. A 4-month-old Arab baby boy developed dermal necrotizing granulomatous giant cell reaction at the injection site (right anterior thigh) of the second dose of 13-valent pneumococcal conjugate vaccine. Ziehl-Neelsen and periodic-acid Schiff were negative. This reaction probably resulted from improper intramuscular administration because the first (at 2 months of age) and third (at 10 months of age) doses were uneventful.Conclusions: Dermal necrotizing granulomatous reactions are a serious complication of the 13-valent pneumococcal conjugate vaccine. Health care providers need to administer this preparation deeply into a muscle mass. Completing the vaccine series is an acceptable option. Physicians are encouraged to report their experience with completing vaccine series following adverse events.
KW - Adjuvants
KW - Adverse events
KW - Necrotizing granulomatous giant cell reaction
KW - Pneumococcal conjugate vaccine
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U2 - 10.1186/1752-1947-8-285
DO - 10.1186/1752-1947-8-285
M3 - Article
C2 - 25152179
AN - SCOPUS:84908506379
SN - 1752-1947
VL - 8
JO - Journal of Medical Case Reports
JF - Journal of Medical Case Reports
IS - 1
M1 - 285
ER -