Acute encephalomyelitis in a 52-year-old male post messenger ribonucleic acid severe acute respiratory syndrome coronavirus 2 vaccination: a case report

J Med Case Rep. 2023 May 5;17(1):202. doi: 10.1186/s13256-023-03831-2.

Abstract

Background: Acute disseminated encephalomyelitis is a well-known, but rare, side effect of some vaccines, or symptom following a febrile illness.

Case: A 69-year-old, otherwise healthy Hispanic male presented with acute fever, confusion, and later progressive weakness after receiving the first dose of the mRNA-1273 (Moderna) severe acute respiratory syndrome coronavirus 2 vaccine. Considering the progressive deterioration of the patient, despite being on multiple immunosuppressive agents, a brain biopsy was obtained, which revealed nonspecific meningoencephalitis.

Conclusion: In this case, we highlight the need for a regulatory framework to assist clinicians and patients with coverage of treatment for acute disseminated encephalomyelitis. The use of intravenous immunoglobulin in conjunction with glucocorticoids seems to be an effective treatment option.

Keywords: ADEM; COVID vaccine; Myelitis; Vaccine adverse effects.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • COVID-19*
  • Encephalomyelitis* / chemically induced
  • Encephalomyelitis, Acute Disseminated* / chemically induced
  • Humans
  • Male
  • Middle Aged
  • RNA / therapeutic use
  • SARS-CoV-2
  • Vaccination
  • Vaccines* / adverse effects

Substances

  • Vaccines
  • RNA