Received Apr 12, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| PPV | PNEUMO (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | OT |
| PPV | PNEUMO (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | OT |
| PPV | PNEUMO (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | OT |
Miller Fisher Syndrome; This literature marketed report was received from the authors in a published literature article, concerning a 70-year-old female patient. Information regarding the patients' concurrent conditions, medical history or concomitant medications was not provided. On unknown dates, the patient was vaccinated with an unspecified pneumococcal vaccine (Manufacturer unknown) for prophylaxis (strength, route of administration, lot # and expiration date were not reported). 8 days after receiving the vaccine, the patient presented to the emergency room with headache, diplopia, and limb paresthesia. Initial neuroimaging showed white matter disease and segmental occlusion of the distal left vertebral artery with reconstitution. Lumbar puncture (LP) was performed, and cerebrospinal fluid showed elevated WBCs with neutrophil predominance, elevated protein and normal glucose. Additional autoimmune, inflammatory and paraneoplastic workup was sent while broad-spectrum antimicrobial treatment for suspected meningitis was initiated. She was subsequently intubated for worsening encephalopathy and hypoxic, hypercapnic respiratory failure and admitted to the Intensive Care Unit. MRI/MRV Brain was negative. EEG showed Delta- Theta coma. Serial neurological exams revealed coma with ocular square wave jerks. Repeat MRI Brain with and without contrast was suspicious for bilateral hippocampal enhancement thought to be possible brainstem or limbic encephalitis. LP was repeated with resolving pleocytosis, and subsequent exam showed purposeful vertical eye movements. Intravenous immunoglobulin was initiated and GM1 antibody test returned positive, confirming the suspicion of post-PV MF syndrome. The outcome of the event was unknown. The event was considered related to the pneumococcal vaccine.
Test Name: neuroimaging; Result Unstructured Data: white matter disease and segmental occlusion of the distal left vertebral artery with reconstitution; Test Name: Lumbar puncture (LP); Result Unstructured Data: cerebrospinal fluid showed elevated WBCs with neutrophil predominance, elevated protein and normal glucose.; Test Name: MRI/MRV Brain; Test Result: Negative ; Test Name: EEG; Result Unstructured Data: Delta-Theta coma.; Test Name: neurological exams; Result Unstructured Data: coma with ocular square wave jerks.; Test Name: MRI Brain with and without contrast; Result Unstructured Data: suspicious for bilateral hippocampal enhancement thought to be possible brainstem or limbic encephalitis.; Test Name: LP; Result Unstructured Data: resolving pleocytosis, and subsequent exam showed purposeful vertical eye movements.; Test Name: GM1 antibody test; Test Result: Positive