Eosinophilic myocarditis temporally associated with conjugate meningococcal C and hepatitis B vaccines in children.
We report the first cases of tissue-proven eosinophilic myocarditis after single vaccine administration of conjugate meningococcal C and hepatitis B vaccine, respectively. The nature of histopathologic findings strongly supports hypersensitivity reaction and negates viral etiology, which is typically characterized by a lymphocytic infiltrate. Both episodes resolved with corticosteroid therapy. To enhance discussion of our cases, we performed a systematic review of the literature on postimmunization myocarditis or pericarditis, and identified 37 publications, reporting 269 cases during the search period (1966-2007). Time of onset of cardiac symptoms in all patients ranged from 1 to 30 days postimmunization.
Barton
Michelle
M
Division of Infectious Diseases, the Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada.
Finkelstein
Yaron
Y
Opavsky
Mary Anne
MA
Ito
Shinya
S
Ho
Tommy
T
Ford-Jones
Lee E
LE
Taylor
Glenn
G
Benson
Lee
L
Gold
Ronald
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D004804:Eosinophils / Q000276:immunology*; D005260:Female; D017325:Hepatitis B Vaccines / Q000009:adverse effects*; D006801:Humans; D006967:Hypersensitivity; D022401:Meningococcal Vaccines / Q000009:adverse effects*; D009205:Myocarditis / Q000276:immunology / Q000473:pathology*
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D017325:Hepatitis B Vaccines; D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine