[Severe Yellow fever vaccine-associated disease: a case report and current overview]

History and physical examination A 56-year-old man developed high fever with severe headaches, fatigue, impaired concentration skills, and an exanthema 5 days after a yellow fever (YF) vaccination. Laboratory tests Liver enzymes and YF antibody titers were remarkably elevated. YF vaccine virus was detected in urine by PCR. Diagnosis and therapy Initially, severe YF vaccine-associated visceral disease was suspected and treated symptomatically. Clinical Course His fever ceased after 10 days in total, no organ failure developed. However, postencephalitic symptoms persisted with fatigue and impaired concentration, memory, and reading skills and partly incapability to work for over 3 months. A diagnosis was made of suspected YF vaccine-associated neurotropic disease. Conclusion Severe vaccine-derived adverse effects need to be considered in the indication process for YF vaccination.