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Subacromial bursitis following human papilloma virus vaccine misinjection
Soshi Uchida1, Akinori Sakai, Toshitaka Nakamura
1Department of Orthopaedic Surgery, Wakamatsu Hospital for the University of Occupational and Environmental Health Japan, 1-17-1 Hamamachi, Wakamatsu Kitakyushu, Fukuoka 808-0024, Japan. soushi@med.uoeh-u.ac.jp
Abstract:
A patient presented at our clinic with severe subacromial bursitis, which persisted for several months following a third booster injection with Cervarix™. Chronic subacromial bursitis manifested itself in this patient after what appeared to be the misinjection of vaccine in close proximity to the acromion. This bursitis was resistant to conventional physiotherapy and to corticosteroid therapy, but was responsive to arthroscopic surgery. Since such patients may present to an arthroscopic surgeon only months after receiving a vaccine injection, this etiological link may not be fully appreciated by treating clinicians. Further, the accuracy of injection in the deltoid region also appears under appreciated, and this report highlights the importance of accurate injection to the deltoid region or in certain cases, the value of simply changing the injection site to another larger muscle.
Insights
A patient developed chronic subacromial bursitis after a vaccine injection near the acromion. Arthroscopic surgery resolved the condition, highlighting the importance of accurate vaccine deltoid injection technique.
Area of Science:
- Orthopedics
- Immunology
- Vaccinology
Background:
- Subacromial bursitis is a common condition causing shoulder pain and limited mobility.
- Vaccine injections in the deltoid muscle are routine for many immunizations.
- Accurate vaccine administration is crucial to prevent local complications.
Observation:
- A patient presented with persistent, severe subacromial bursitis.
- The bursitis developed months after receiving a third booster injection of Cervarix™.
- The injection appeared to be administered in close proximity to the acromion.
Findings:
- The patient's subacromial bursitis was resistant to conservative treatments like physiotherapy and corticosteroid therapy.
- Arthroscopic surgery provided a successful resolution of the bursitis.
- This case suggests a potential etiological link between incorrect vaccine injection site and subacromial bursitis.
Implications:
- Clinicians should consider vaccine injection site as a potential cause of subacromial bursitis, especially when symptoms persist.
- Accurate landmark identification and injection technique in the deltoid region are critical for preventing adverse events.
- Alternative injection sites may be considered in certain cases to minimize risks.
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