title: [YEL-AND meningoencephalitis in a 4-year-old boy consecutive to a yellow-fever vaccine].
abstract: Yellow fever is a vector-borne disease transmitted by an endemic mosquito in sub-Saharan Africa and tropical South America. It causes fever and possibly liver and renal failure with hemorrhagic signs, which may be fatal. The yellow-fever vaccine is an attenuated vaccine that is recommended for all travelers over the age of 9 months in high-risk areas. Adverse effects have been reported: minor symptoms (such as viral syndrome), hypersensitivity reactions, and major symptoms such as viscerotropic disease (YEL-AVD) and neurotropic disease (YEL-AND). The yellow-fever vaccine-associated autoimmune disease with central nervous system involvement (such as acute disseminated encephalomyelitis) associates fever and headaches, neurologic dysfunction, seizures, cerebrospinal fluid (CSF) pleocytosis, and elevated protein, with neuroimaging consistent with multifocal areas of demyelization. The presence of antibodies or virus in CSF, within 1-30 days following vaccination, and the exclusion of other causes is necessary for diagnosis. We describe herein the case of a 4-year-old child who presented with severe encephalitis consecutive to a yellow-fever vaccine, with favorable progression. Diagnosis is based on the chronology of clinical and paraclinical signs and the presence of yellow-fever-specific antibodies in CSF. The treatment consists of symptomatic treatment and immunoglobulin injection.
authors.affiliation: Clinique universitaire de pédiatrie, hôpital couple-enfant, 38000 Grenoble, France. Electronic address: mgerin@chu-grenoble.fr.
authors.forename: M
authors.initials: M
authors.lastname: Gerin
authors.affiliation: Clinique universitaire de réanimation pédiatrique et médecine néonatale, hôpital couple-enfant, 38000 Grenoble, France.
authors.forename: I
authors.initials: I
authors.lastname: Wroblewski
authors.affiliation: Clinique universitaire de pédiatrie, hôpital couple-enfant, 38000 Grenoble, France.
authors.forename: C
authors.initials: C
authors.lastname: Bost-Bru
authors.affiliation: Clinique universitaire de pédiatrie, hôpital couple-enfant, 38000 Grenoble, France.
authors.forename: M-A
authors.initials: MA
authors.lastname: N'guyen
authors.affiliation: Clinique universitaire de réanimation pédiatrique et médecine néonatale, hôpital couple-enfant, 38000 Grenoble, France.
authors.forename: T
authors.initials: T
authors.lastname: Debillon
mesh_terms: D000914:Antibodies, Viral / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002675:Child, Preschool; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage / Q000627:therapeutic use; D007155:Immunologic Factors / Q000134:cerebrospinal fluid; D008297:Male; D008590:Meningoencephalitis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*; D013577:Syndrome; D016896:Treatment Outcome; D015004:Yellow Fever / Q000517:prevention & control; D022341:Yellow Fever Vaccine / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D015005:Yellow fever virus / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D007136:Immunoglobulins; D007155:Immunologic Factors; D022341:Yellow Fever Vaccine