Beveridge Mara G, Polcari Ingrid C, Burns Jennifer L, Adler Amos, Hendrickson Barbara, Stein Sarah L
Section of Dermatology, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois 60637, USA.
Pediatr Dermatol. 2012 Jan-Feb;29(1):68-72. doi: 10.1111/j.1525-1470.2011.01541.x. Epub 2011 Aug 19.
Childhood vaccines are a routine part of pediatric care in the United States; clinicians must be able to recognize and interpret associated localized adverse reactions. Redness and induration at the site of injection are commonly reported and are considered to be the result of local inflammation or hematoma formation, although other atypical reactions can occur. We report the case of a 6-month-old infant who developed subcutaneous nodules at the sites of his 4- and 6-month Pentacel (DTaP/Hib/IPV, diphtheria, tetanus, acellular pertussis, Haemophilus b conjugate, and inactivated poliovirus vaccine) and 6-month Prevnar (heptavalent pneumococcal vaccine) injections. Infectious disease and immunodeficiency examinations were unremarkable. Aluminum contact allergy was considered, and contact allergy testing confirmed sensitivity to aluminum. Although rare, aluminum contact allergy after routine immunization can occur and should be considered in the differential diagnosis of persistent subcutaneous nodules after vaccination.
儿童疫苗接种是美国儿科护理的常规内容；临床医生必须能够识别和解读相关的局部不良反应。注射部位出现发红和硬结是常见报告症状，通常被认为是局部炎症或血肿形成的结果，不过也可能发生其他非典型反应。我们报告了一例6个月大婴儿的病例，该婴儿在4个月和6个月接种五联疫苗（白百破/ Hib/ IPV，即白喉、破伤风、无细胞百日咳、b型流感嗜血杆菌结合疫苗和灭活脊髓灰质炎病毒疫苗）以及6个月接种沛儿疫苗（七价肺炎球菌疫苗）的注射部位出现了皮下结节。传染病和免疫缺陷检查结果均无异常。考虑到铝接触过敏的可能性，接触过敏测试证实该婴儿对铝敏感。尽管罕见，但常规免疫接种后铝接触过敏仍有可能发生，在接种疫苗后持续性皮下结节的鉴别诊断中应予以考虑。
