Journal article
Meningitis Caused by the Live Varicella Vaccine Virus: Metagenomic Next Generation Sequencing, Immunology Exome Sequencing and Cytokine Multiplex Profiling
Viruses, Vol.13(11), p.2286
11/16/2021
DOI: 10.3390/v13112286
PMCID: PMC8620440
PMID: 34835092
Abstract
Varicella vaccine meningitis is an uncommon delayed adverse event of vaccination. Varicella vaccine meningitis has been diagnosed in 12 children, of whom 3 were immunocompromised. We now report two additional cases of vaccine meningitis in twice-immunized immunocompetent children and we perform further testing on a prior third case. We used three methods to diagnose or investigate cases of varicella vaccine meningitis, none of which have been used previously on this disease. These include metagenomic next-generation sequencing and cytokine multiplex profiling of cerebrospinal fluid and immunology exome analysis of white blood cells. In one new case, the diagnosis was confirmed by metagenomic next-generation sequencing of cerebrospinal fluid. Both varicella vaccine virus and human herpesvirus 7 DNA were detected. We performed cytokine multiplex profiling on the cerebrospinal fluid of two cases and found ten elevated biomarkers: interferon gamma, interleukins IL-1RA, IL-6, IL-8, IL-10, IL-17F, chemokines CXCL-9, CXCL-10, CCL-2, and G-CSF. In a second new case, we performed immunology exome sequencing on a panel of 356 genes, but no errors were found. After a review of all 14 cases, we concluded that (i) there is no common explanation for this adverse event, but (ii) ingestion of an oral corticosteroid burst 3–4 weeks before onset of vaccine meningitis may be a risk factor in some cases.
Details
- Title: Subtitle
- Meningitis Caused by the Live Varicella Vaccine Virus: Metagenomic Next Generation Sequencing, Immunology Exome Sequencing and Cytokine Multiplex Profiling
- Creators
- Prashanth Ramachandran - University of California, San FranciscoMichael Wilson - University of California [San Francisco]Gaud Catho - Geneva University Hospitals and Geneva UniversityGeraldine Blanchard-Rohner - Geneva University Hospitals and Geneva UniversityNicoline Schiess - Johns Hopkins University School of MedicineRandall Cohrs - University of Colorado Anschutz [Aurora]David Boutolleau - Institut Pierre Louis d'Epidémiologie et de Santé PubliqueSonia Burrel - Institut Pierre Louis d'Epidémiologie et de Santé PubliqueTetsushi Yoshikawa - Fujita Health UniversityAnne Wapniarski - University of California [San Francisco]Ethan Heusel - University of IowaJohn Carpenter - University of IowaWallen Jackson - University of IowaBradley Ford - University of IowaCharles Grose - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Viruses, Vol.13(11), p.2286
- DOI
- 10.3390/v13112286
- PMID
- 34835092
- PMCID
- PMC8620440
- NLM abbreviation
- Viruses
- ISSN
- 1999-4915
- eISSN
- 1999-4915
- Publisher
- MDPI
- Grant note
- DOI: 10.13039/100005339, name: American Academy of Neurology, award: P0534134; DOI: 10.13039/100000065, name: National Institute of Neurological Disorders and Stroke, award: NS096117; DOI: 10.13039/100000060, name: NIAID, award: AI153817
- Language
- English
- Date published
- 11/16/2021
- Academic Unit
- Stead Family Department of Pediatrics; Pathology; Infectious Disease (Pediatrics)
- Record Identifier
- 9984200020802771
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