Sudden death after typhoid and Japanese encephalitis vaccination in a young male taking pseudoephedrine.
The case of a 21-year-old male taking over-the-counter pseudoephedrine for weight loss who died suddenly during exercise shortly after inoculation with Japanese encephalitis and phenol-inactivated typhoid vaccines is presented. The patient collapsed in mild weather while exercising 75 minutes after his vaccinations. He presented in asystole with a core temperature of 42.2 degrees C (108 degrees F). There was no evidence of urticaria or angioedema. It is likely that the combined pyrogenic effects of the vaccines, pseudoephedrine, exercise, and mild obesity contributed to a failure of the thermoregulatory system. Fever is still a common side effect of numerous other vaccines. Military physicians should consider administrative controls on thermogenic activities for a period after inoculations. Additionally, the dangers of ephedrine-containing compounds need to be more widely publicized.
Franklin
Q J
QJ
3rd AABN, 1st Marine Division, Camp Pendleton, CA 92055-5300, USA.
D000328:Adult; D001067:Appetite Depressants / Q000009:adverse effects*; D002423:Cause of Death; D003645:Death, Sudden / Q000209:etiology*; D004672:Encephalitis, Japanese / Q000276:immunology*; D004809:Ephedrine / Q000009:adverse effects*; D015444:Exercise; D018882:Heat Stress Disorders / Q000209:etiology*; D006801:Humans; D008297:Male; D008889:Military Personnel; D009765:Obesity / Q000150:complications* / Q000188:drug therapy; D014436:Typhoid-Paratyphoid Vaccines / Q000009:adverse effects*; D014765:Viral Vaccines / Q000009:adverse effects*
D001067:Appetite Depressants; D014436:Typhoid-Paratyphoid Vaccines; D014765:Viral Vaccines; D004809:Ephedrine