Received Jun 20, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| YF | YELLOW FEVER (YF-VAX) | SANOFI PASTEUR | 1 | UK134AA | SC |
Initially had local injection site reaction (common reaction) with regional lymphadenopathy but hen developed what patient described as brain fog and non-vertiginous, one episode of pre-syncopal dizziness followed by non-specific, non-presyncopal, dizziness. His symptoms persisted although he tried to work, it was interfering with his desk job and was very tired. There were no definite fevers or focal neurological symptoms or headache at time. His arm inflammation responded very nicely to moderate doses of ibuprofen. He got significantly worse with activity. I followed him closely by phone then saw him in office 5/21 and the arm and regional nodes were essentially resolved back to normal. His exam was reassuring and seemed like a viral syndrome with encephalopathy from YF vaccination. He called 2 days later that he now had headache and I referred to ED for MRI and LP. He looked too well to the ED staff with a normal physical exam and only non-contrast MRI was done which was normal. He was sent home. He felt worse and family encouraged ED visit and this time to another hospital 5/28/25. His exam was reassuring but had LP and revealed CSF pleocytosis. He was seen by Neurology and Inf Dis consultation services and monitored for 24 hrs. CDC was consulted regarding YEL-AND and CSF was sent to CDC. Other tests were done and negative including syphilis. He had worse headache that was due to lumbar puncture and was sent home on analgesics. After DC to home he called complaining of ongoing symptoms and HA was not improved and had new back stiffness. I arranged for blood patch and this resolved those symptoms. His dizziness and brain fog persisted and had new peripheral sensory and motor symptoms and I worried about ADEM and GBS vs anxiety. He went back to our ED and was admitted for ruled out. He had another neurology consult and contrast brain MRI which was reassuringly normal. There was no meningismus or hallucinations and there were no seizure-like symptoms. Drug screen was negative and EEG was not done. He was discharged home and since has improved
none
none
sertraline 25 mg daily
lobster
Normal Brain MRI 5/28/25 and MRI with contrast 6/6/25 also normal, 6/6/25 CSF WBC 39 with 96% lymphocytes in tube 4. CSF protein was normal at 20 mg/dl. Syphilis screen was negative. Urine toxicology was neg 6/6/25. HIV and Lyme disease screens negative 5/27/25.
Pfizer mRNA COVID-19 vaccinations produce fever, chills and fatigue for 3-4 days. 12/4/22 was last