RESUMO
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Assuntos
Humanos , Masculino , Pré-Escolar , Vacinas Combinadas/efeitos adversos , Erupção por Droga/etiologia , Eritema Endurado/induzido quimicamente , Vacina Antipólio de Vírus Inativado/efeitos adversos , Vacina contra Difteria, Tétano e Coqueluche/efeitos adversos , Vacinas contra Hepatite B/efeitos adversos , Vacinas Anti-Haemophilus/efeitos adversos , Testes do Emplastro , Testes IntradérmicosAssuntos
Antirreumáticos/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Certolizumab Pegol/efeitos adversos , Eritema Endurado/induzido quimicamente , Tuberculose dos Linfonodos/diagnóstico , Tuberculose dos Linfonodos/tratamento farmacológico , Idoso , Antituberculosos/uso terapêutico , Biópsia , Diagnóstico Diferencial , Quimioterapia Combinada , Etambutol , Feminino , Humanos , Perna (Membro) , Reação em Cadeia da PolimeraseRESUMO
INTRODUCTION: Adjuvants (for example, aluminum salts) are frequently incorporated in licensed vaccines to enhance the host immune response. Such vaccines include the pneumococcal conjugate, combinations of diphtheria-tetanus/acellular pertussis, tetanus- diphtheria/acellular pertussis, hepatitis B, some Haemophilus influenzae type b, hepatitis A, and human papillomavirus. These preparations have been associated with complicated local adverse events, especially if administered subcutaneously or intradermally in comparison to deep intramuscular injection. We describe a severe inflammatory reaction at the site of an injection of 13-valent pneumococcal conjugate vaccine. CASE PRESENTATION: A 4-month-old Arab baby boy developed dermal necrotizing granulomatous giant cell reaction at the injection site (right anterior thigh) of the second dose of 13-valent pneumococcal conjugate vaccine. Ziehl-Neelsen and periodic-acid Schiff were negative. This reaction probably resulted from improper intramuscular administration because the first (at 2 months of age) and third (at 10 months of age) doses were uneventful. CONCLUSIONS: Dermal necrotizing granulomatous reactions are a serious complication of the 13-valent pneumococcal conjugate vaccine. Health care providers need to administer this preparation deeply into a muscle mass. Completing the vaccine series is an acceptable option. Physicians are encouraged to report their experience with completing vaccine series following adverse events.
Assuntos
Eritema Endurado/induzido quimicamente , Células Gigantes/efeitos dos fármacos , Granuloma/induzido quimicamente , Vacinas Pneumocócicas/efeitos adversos , Vacinação/efeitos adversos , Antibacterianos/uso terapêutico , Biópsia , Cefixima/uso terapêutico , Diagnóstico Diferencial , Eritema Endurado/complicações , Células Gigantes/patologia , Granuloma/complicações , Granuloma/patologia , Humanos , Lactente , Inflamação/induzido quimicamente , Inflamação/complicações , Inflamação/patologia , Infecções por Klebsiella/complicações , Infecções por Klebsiella/tratamento farmacológico , Masculino , Necrose/induzido quimicamente , Necrose/complicações , Coxa da Perna/patologia , Vacinas Conjugadas/efeitos adversosRESUMO
We report the first case of erythema induratum of Bazin (EIB) after Bacille Calmette-Guerin (BCG) vaccination in an infant. The patient developed recurrent multiple erythematous and subcutaneous nodules on his legs 2 months after a BCG vaccination. He had no other symptoms or family history of tuberculosis (TB). Histopathological findings revealed a granulomatous lobular panniculitis. EIB often appears as a chronic, nodular eruptions that frequently occur on the lower legs of females with tuberculin hypersensitivity. To date, only a few cases of infants with EIB have been reported. There have been no clinical reports of EIB after BCG vaccination. Our case suggests that Mycobacterium bovis in the BCG vaccination may have caused EIB.
Assuntos
Adjuvantes Imunológicos/efeitos adversos , Vacina BCG/efeitos adversos , Eritema Endurado/induzido quimicamente , Eritema Endurado/patologia , Humanos , Lactente , MasculinoRESUMO
Leukotriene-modifying drugs are novel agents introduced recently to treat asthma. Both 5-lipoxygenase inhibitors, such as zileuton, and leukotriene receptor antagonists, such as zafirlukast and montelukast, have proved effective in the treatment of asthma. To our knowledge, there have been no detailed reports regarding dermatologic manifestations of this class of drugs. This article describes an unusual case of erythema nodosum in a 46-year-old asthmatic man who received 2 different leukotriene modifiers.
