TAILIEUCHUNG - Báo cáo y học: "Possible life-threatening adverse reaction to monovalent H1N1 vaccine"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Possible life-threatening adverse reaction to monovalent H1N1 vaccine. | Bhurayanontachai Critical Care 2010 14 422 http content 14 3 422 CRITICAL CARE LETTER L_ Possible life-threatening adverse reaction to monovalent H1N1 vaccine Rungsun Bhurayanontachai The vaccine against H1N1 was initially issued in July 2009 with no doubts regarding its beneficial immunoprotective effect 1 2 . Recent reports have shown that adverse events are few and generally not life-threatening 3 . Therefore a worldwide vaccination program was launched with very strong confidence 4 . Herein for the accumulative record I report a possible life-threatening reaction of the monovalent H1N1 vaccine in Thailand. A 38-year-old pregnant woman gestational age of 25 weeks was fit and well and had regular antenatal care without any problems. She was given an H1N1 vaccination and the following day developed diffuse myalgia and minimal shortness of breath. Her condition continued to deteriorate ultimately ending in respiratory failure on day 5 post-vaccination. On arrival at the intensive care unit she was tachypneic tachycardic and hypotensive. Her chest film demonstrated diffuse bilateral lung infiltration. She was eventually intubated and ventilated with high-concentration oxygen and high positive end-expiratory pressure. She was found to have bloody secretions from tracheal aspiration. Acute lung injury with pulmonary hemorrhage was therefore suspected. A complete physical examination revealed a severe bilateral subconjunctival hemorrhage. No other abnormalities were detected. Blood labs showed a leucopenia level of 2 600 mm3 mild anemia with hemoglobin of 10 gm dL and a platelet count of 40 000 mm3. A coagulation study was normal. She was also suffering from acute renal failure with a creatinine level of 3 mg dL. Urinalysis demonstrated proteinuria with a quantitative count of around gm L with microscopic hematuria. A liver function test also showed mild transaminitis. Microbiological study and culture were negative. An echocardiogram showed .

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