Elsevier

IDCases

Volume 27, 2022, e01452
IDCases

Case report
Zoster meningitis in an immunocompetent young patient post first dose of BNT162b2 mRNA COVID-19 vaccine, a case report

https://doi.org/10.1016/j.idcr.2022.e01452Get rights and content
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open access

Abstract

Recently published observational data suggests an increased risk of herpes zoster infection post-vaccination with the BNT162b2 mRNA vaccine. We describe the case of VZV meningitis post BNT162b2 mRNA vaccination in a young immunocompetent patient. A 39-year-old patient with no medical history presented with a vesicular rash, headache, nausea and fever, days after receiving BNT162b2 mRNA vaccination. CSF analysis revealed a pleocytosis, and VZV DNA was confirmed by PCR testing. The patient received intravenous aciclovir with resolution of symptoms within 48 h. He was discharged after 14 days of treatment. Case reports of herpes zoster reactivation post vaccination and details of subsequent successful vaccination course completion have allowed us to recommend the patient receive his second dose of the BNT162b2 mRNA vaccine. At the time of writing, however, the patient has declined to receive further vaccination due to fears of an adverse event. To the best of our knowledge, this is the first reported case in a young patient of herpes zoster meningitis following COVID-19 mRNA vaccination. The sharing of clinical experiences and reporting of suspected side effects, particularly for vaccines that employ novel technology, increases knowledge of the safety profile of these vaccines and allows clinicians to better aid patients make informed decisions with regard to commencing and completing vaccination.

Abbreviations

CSF
cerebrospinal fluid
CT
computed tomography
DNA
deoxyribonucleic acid
GP
general practitioner
HIV
human immunodeficiency virus
mRNA
messenger ribonucleic acid
RNA
ribonucleic acid
RT-PCR
reverse transcriptase polymerase chain reaction
PCR
polymerase chain reaction
WBC
white blood cell count
VZV
varicella zoster virus

Keywords

COVID-19
MRNA
Vaccine
Zoster
Meningitis

Data availability

Not applicable.

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