Severe Immune Thrombocytopenia and Myositis After 23-Valent Pneumococcal Vaccine

An adolescent patient developed a severe local inflammatory reaction, acute kidney injury, extensive myofascitis, and profound immune thrombocytopenia resulting in vitreous hemorrhage and long-term permanent visual impairment after 23-valent polysaccharide pneumococcal vaccine administration. This severe adverse outcome has not previously been reported in the literature with this particular vaccination. This case highlights rare but serious potential adverse immunologic effects of polysaccharide vaccines.