2021
DOI: 10.1136/bcr-2021-243173
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Acute encephalitis, myoclonus and Sweet syndrome after mRNA-1273 vaccine

Abstract: A patient presented with fever, generalised rash, confusion, orofacial movements and myoclonus after receiving the first dose of mRNA-1273 vaccine from Moderna. MRI was unremarkable while cerebrospinal fluid showed leucocytosis with lymphocyte predominance and hyperproteinorrachia. The skin evidenced red, non-scaly, oedematous papules coalescing into plaques with scattered non-follicular pustules. Skin biopsy was consistent with a neutrophilic dermatosis. The patient fulfilled the criteria for Sweet syndrome. … Show more

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Cited by 51 publications
(49 citation statements)
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“…Three of five erythema multiforme cases were associated with the mRNA-1273 vaccine [ 1 , 62 , 63 ]. New onset of prurigo nodularis [ 17 ], radiation recall dermatitis [ 64 ], symmetrical drug-related intertriginous and flexural exanthema (SDRIFE)-like eruption [ 65 ], Stevens-Johnson syndrome/toxic epidermal necrolysis [ 66 , 67 , 68 ], Sweet’s syndrome [ 69 , 70 ], vitiligo [ 71 ], vasculitis [ 50 , 72 , 73 ], livedo racemosa [ 27 ], fixed drug eruption [ 27 ], pityriasis rubra pilaris-like eruption [ 74 ], and facial pustular neutrophilic eruption [ 75 ] have been reported post-vaccination. All SJS and Sweet’s syndrome cases were managed successfully.…”
Section: Resultsmentioning
confidence: 99%
“…Three of five erythema multiforme cases were associated with the mRNA-1273 vaccine [ 1 , 62 , 63 ]. New onset of prurigo nodularis [ 17 ], radiation recall dermatitis [ 64 ], symmetrical drug-related intertriginous and flexural exanthema (SDRIFE)-like eruption [ 65 ], Stevens-Johnson syndrome/toxic epidermal necrolysis [ 66 , 67 , 68 ], Sweet’s syndrome [ 69 , 70 ], vitiligo [ 71 ], vasculitis [ 50 , 72 , 73 ], livedo racemosa [ 27 ], fixed drug eruption [ 27 ], pityriasis rubra pilaris-like eruption [ 74 ], and facial pustular neutrophilic eruption [ 75 ] have been reported post-vaccination. All SJS and Sweet’s syndrome cases were managed successfully.…”
Section: Resultsmentioning
confidence: 99%
“…One case of Sweet syndrome accompanied by acute encephalitis was described in a 77-year-old man after the first dose of the mRNA-1273 vaccine [55]. There are sporadic reports of fixed drug eruptions [6,18,56].…”
Section: Other Dermatosesmentioning
confidence: 99%
“…To our knowledge, only three cases of Sweet's syndrome after Covid-19 vaccines have been reported [9][10][11] and only one of them after the BNT162b2 vaccine [10] (Table 1). One of them, as in our case, had only cutaneous involvement and was related to BNT162b2; the other two also displayed extracutaneous manifestations such as arthritis, polymyositis, acute encephalitis, and myoclonus and were associated with other COVID-19 vaccines.…”
Section: Discussionmentioning
confidence: 97%