title: Bone erosion and subacromial bursitis caused by diphtheria-tetanus-poliomyelitis vaccine.
abstract: Revaxis(®) is a vaccine against diphtheria, tetanus and poliomyelitis (dT-IPV). This vaccine should not be administered by the intradermal or intravenous route. Poor injection techniques and related consequences are rare. We report a case of bursitis associated with reactive glenohumeral effusion complicated by bone erosion occurring after injection of the dT-IPV vaccine. A 26 year old patient was admitted for painful left shoulder causing functional impairment. Control magnetic resonance imaging showed bone oedema on the upper outer part of the humeral head, with a slight cortical irregularity, indicating that the vaccine was injected in contact with the bone at this location, causing erosion. Outcome was favourable after intra-articular corticosteroids. Reports of articular or periarticular injury after vaccination are extremely rare, in view of the substantial number of vaccines administered every year. The potential complications of vaccination are well known to general practitioners but under-reported in the literature.
authors.affiliation: Rheumatology Department, Maison Blanche Hospital, Reims University Hospitals, Reims F-51092, France; University of Reims Champagne-Ardenne, Faculty of Medicine, EA 3797, Reims F-51095, France. Electronic address: jhsalmon@chu-reims.fr.
authors.forename: J H
authors.initials: JH
authors.lastname: Salmon
authors.affiliation: Rheumatology Department, Maison Blanche Hospital, Reims University Hospitals, Reims F-51092, France.
authors.forename: M
authors.initials: M
authors.lastname: Geoffroy
authors.affiliation: Rheumatology Department, Maison Blanche Hospital, Reims University Hospitals, Reims F-51092, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Eschard
authors.affiliation: Orthopedics and Traumatology Department, Maison Blanche Hospital, Reims University Hospitals, Reims F-51092, France.
authors.forename: X
authors.initials: X
authors.lastname: Ohl
mesh_terms: D000328:Adult; D001862:Bone Resorption / Q000139:chemically induced* / Q000453:epidemiology*; D002062:Bursitis / Q000139:chemically induced* / Q000453:epidemiology*; D022422:Diphtheria-Tetanus Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006811:Humerus / Q000473:pathology; D011054:Poliovirus Vaccine, Inactivated / Q000008:administration & dosage / Q000009:adverse effects*; D012785:Shoulder Joint / Q000473:pathology; D017778:Vaccines, Combined / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D022422:Diphtheria-Tetanus Vaccine; D011054:Poliovirus Vaccine, Inactivated; D017778:Vaccines, Combined
keywords: Adverse event; Bursitis; Diphtheria tetanus and poliomyelitis vaccine (dT-IPV); Osteolysis