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一例由风疹疫苗引起的风疹病例。

A Case of Rubella Caused by Rubella Vaccination.

作者信息

Kamada Momoka, Kenzaka Tsuneaki

机构信息

Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, 2002-7 Iso, Hikami-cho, Tamba 669-3495, Japan.

Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5 Arata-cho, Hyogo-ku, Kobe 652-0032, Japan.

出版信息

Vaccines (Basel). 2021 Sep 18;9(9):1040. doi: 10.3390/vaccines9091040.

Abstract

We present an extremely rare case of rubella that developed after rubella vaccine administration. A 54-year-old man complained of back and neck pain for some days. He presented with generalized rash and arthralgia that had persisted for two days before his visit. His vital signs were normal, and arthralgia had disappeared during an examination, but lymphadenopathy in the left posterior neck and pink papules were observed throughout the body. He had received his first Rubella vaccination 17 days before this visit and had attended a crowded festival. Owing to the rubella epidemic in that prefecture, we performed a rubella antibody test and polymerase chain reaction assay using blood, urine, and pharyngeal swab specimens. Rubella IgG and IgM antibody titers were 3 and 1.48, respectively. The pharyngeal swab yielded positive results for the 1a vaccine strain. Therefore, he was diagnosed with rubella due to rubella vaccination. His symptoms improved eventually. His clinical course was uncomplicated. Symptoms resolved within one week without specific treatment. The vaccine rubella strain is not as highly infectious as wild-type rubella strains. If rubella symptoms appear after vaccination, it must be investigated whether these are vaccine-specific adverse reactions, wild-strain rubella onset, or other eruptive viral infections.

摘要

我们报告一例极为罕见的风疹病例,该病例在接种风疹疫苗后发病。一名54岁男性抱怨背部和颈部疼痛数日。他就诊前出现全身皮疹和关节痛,已持续两天。他的生命体征正常,检查期间关节痛消失,但左后颈部出现淋巴结病,全身可见粉红色丘疹。他在此次就诊前17天接种了第一剂风疹疫苗,并且参加了一个拥挤的节日活动。由于该辖区爆发风疹疫情,我们使用血液、尿液和咽拭子标本进行了风疹抗体检测和聚合酶链反应检测。风疹IgG和IgM抗体滴度分别为3和1.48。咽拭子对1a疫苗株检测呈阳性结果。因此,他被诊断为接种风疹疫苗后感染风疹。他的症状最终有所改善。他的临床过程无并发症。未经特殊治疗,症状在一周内消退。疫苗风疹株的传染性不如野生型风疹株。如果接种疫苗后出现风疹症状,必须调查这些症状是疫苗特异性不良反应、野生株风疹发病还是其他出疹性病毒感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35bb/8473103/fc3cf2429604/vaccines-09-01040-g001.jpg

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