Acute Encephalitis, Myoclonus and Sweet Syndrome After mRNA-1273 Vaccine

Authors

Gabriel Torrealba-Acosta
Jennifer C Martin
Yve Huttenbach
Catherine R Garcia
Muhammad R Sohail
Sandeep Krishna Agarwal
Carina Wasko
Eric M Bershad
Mohammad I Hirzallah

Publication Date

7-26-2021

Journal

BMJ Case Reports

DOI

10.1136/bcr-2021-243173

PMID

34312136

PMCID

PMC8314742

PubMedCentral® Posted Date

7-24-2021

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

2019-nCoV Vaccine mRNA-1273, COVID-19 Vaccines, Encephalitis, Humans, Myoclonus, Sweet Syndrome

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.