Acute encephalitis, myoclonus and Sweet syndrome after mRNA-1273 vaccine

BMJ Case Rep. 2021 Jul 26;14(7):e243173. doi: 10.1136/bcr-2021-243173.

Abstract

A patient presented with fever, generalised rash, confusion, orofacial movements and myoclonus after receiving the first dose of mRNA-1273 vaccine from Moderna. MRI was unremarkable while cerebrospinal fluid showed leucocytosis with lymphocyte predominance and hyperproteinorrachia. The skin evidenced red, non-scaly, oedematous papules coalescing into plaques with scattered non-follicular pustules. Skin biopsy was consistent with a neutrophilic dermatosis. The patient fulfilled the criteria for Sweet syndrome. A thorough evaluation ruled out alternative infectious, autoimmune or malignant aetiologies, and all manifestations resolved with glucocorticoids. While we cannot prove causality, there was a temporal correlation between the vaccination and the clinical findings.

Keywords: COVID-19; dermatology; neurology; unwanted effects / adverse reactions; vaccination/immunisation.

Publication types

  • Case Reports

MeSH terms

  • 2019-nCoV Vaccine mRNA-1273
  • COVID-19 Vaccines
  • Encephalitis* / diagnosis
  • Encephalitis* / etiology
  • Humans
  • Myoclonus* / etiology
  • Sweet Syndrome* / diagnosis
  • Sweet Syndrome* / drug therapy
  • Sweet Syndrome* / etiology

Substances

  • COVID-19 Vaccines
  • 2019-nCoV Vaccine mRNA-1273