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Necrotizing fasciitis following measles vaccine administration: a case report
E E Isere1, A A Fatiregun2, O A Olubosede3
1World Health Organization, Ondo State Field office, Akure, Nigeria. elvisisere@gmail.com.
Background:
The occurrence of adverse events following immunization (AEFI) in national immunization programmes is very rare; however, if they occur causality assessment is conducted to identify the associated cause. In the report, we describe a case of severe necrotizing fasciitis in the left arm of a 9-month old boy following administration of the measles vaccine.
Case Presentation:
A 9-month old boy presented with swelling on the left upper arm and adjoining the chest area, low-grade continuous fever, frequent passage of loose watery stool and persistent cries 24 h after measles vaccine was administered on the left upper arm. On examination, he was mildly pale, febrile, anicteric. Extensive erythema of the left upper arm occurred thereafter with extensive scalded skin lesions involving the deltoid area, the upper chest wall and arm. This was followed by desquamation of the affected areas and severe necrosis. A diagnosis of severe necrotizing fasciitis was made. A causality assessment was conducted by the state AEFI committee using the detailed AEFI investigation forms to identify the cause of the incidence.
Conclusion:
Here we present a rare case of necrotizing fasciitis which could have been caused by incorrect use of reconstituted measles vaccine. Hence we recommend training of routine immunization service providers on proper vaccine management as well as intensified supervision of immunization sessions.
Insights
A rare case of severe necrotizing fasciitis occurred in a 9-month-old boy after measles vaccination. This adverse event following immunization (AEFI) highlights the need for proper vaccine handling and provider training.
Area of Science:
- Pediatric Infectious Diseases
- Vaccine Safety and Adverse Events
Background:
- Adverse events following immunization (AEFI) are rare but require thorough causality assessment.
- National immunization programs aim to prevent disease while monitoring for potential side effects.
Observation:
- A 9-month-old boy developed severe necrotizing fasciitis on his left arm 24 hours after receiving the measles vaccine.
- Symptoms included swelling, fever, and extensive skin lesions progressing to necrosis.
Findings:
- Causality assessment by the state AEFI committee investigated the link between the measles vaccine and the severe necrotizing fasciitis.
- The case suggests a potential link to improper reconstitution or administration of the measles vaccine.
Implications:
- Highlights the critical importance of proper vaccine management and administration techniques.
- Recommends enhanced training and supervision for immunization service providers to prevent rare but severe adverse events.
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