ArticleAnnals of medicine and surgery (2012)2026
Suspected immune-mediated inflammatory myositis with rhabdomyolysis following yellow fever vaccination: a case report.
Article in Annals of medicine and surgery (2012), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The yellow fever vaccine is a live-attenuated vaccine with an excellent safety profile; however, rare adverse events have been reported. Musculoskeletal complications, particularly inflammatory myositis with rhabdomyolysis, are exceedingly uncommon and not well characterized in the literature. Case presentation: We report a case of a 49-year-old man who developed acute febrile illness, severe myalgia, and progressive proximal muscle weakness 1 week after receiving his first yellow fever vaccination. An extensive diagnostic evaluation was performed. The patient presented with high-grade fever and lower-limb proximal muscle weakness, with creatine kinase (CK) peaking at 14 082 U/L and elevated aldolase. Magnetic resonance imaging of the pelvis and bilateral thighs demonstrated diffuse bilateral upper-thigh inflammatory myositis. Electromyography did not reveal any findings suggestive of myopathic disorders. Extensive infectious testing, including viral and travel-related pathogens, was negative. Autoimmune and myositis-specific antibody panels were also negative. Given the temporal association with vaccination, exclusion of alternative etiologies, and supportive imaging findings, a diagnosis of suspected vaccine-associated inflammatory myositis with rhabdomyolysis was made. The patient was treated with high-dose corticosteroids followed by a taper, resulting in rapid clinical and biochemical recovery, with normalization of CK levels and full functional restoration. Conclusion: This case highlights a rare but significant presentation of inflammatory myositis with rhabdomyolysis following yellow fever vaccination. Clinicians should consider this diagnosis in patients presenting with acute muscle weakness and elevated muscle enzymes after recent immunization. Early recognition and appropriate management are essential for favorable outcomes. Despite this rare complication, the overall benefit-to-risk profile of the yellow fever vaccine remains strongly favorable.
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