International Journal of Cardiovascular Sciences. 07/Jul/2020;34(3):330-4.
Reactive Pericarditis post Meningococcal Vaccine: First Case Report in the Literature
Ebrahim Khalid Al-Ebrahim
, Alaa Algazzar
, Mohammed Qutub
Introduction
Autoimmune allergic reaction causing myopericarditis following vaccination is extremely rare and, in this regard, much attention has been paid to smallpox vaccine. Halsell et al., reported 18 cases of probable myopericarditis in 230,734 primary vaccines after smallpox vaccination (an incidence of 7.8 per 100,000 over 30 days). No cases of myopericarditis following smallpox vaccination were reported among 95,622 vaccines who were previously vaccinated. A causal relationship was supported by the close temporal clustering (7-19 days; mean, 10.5 days following vaccination) and wide temporal distribution, occurrence in only primary vaccinees, and lack of evidence for alternative etiologies associated with myopericarditis.
The meningococci causing primary meningococcal pericarditis (PMP) are usually of serotype C (88% of cases in one series) or, less commonly, serotypes B or W135. PMP is a purulent pericarditis caused by N. meningitidis, with no evidence of previous meningococcemia or meningitis, with development of cardiac tamponade in many cases. Evaluation of PMP versus viral pericarditis is important since the former usually requires pericardial drainage in addition to antibiotics.
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