An Unusual Case Of Hemorrhagic Pleuropericarditis After COVID-19 Vaccination

Abstract

As coronavirus disease 2019 vaccines are being increasingly administered worldwide, subsequent side effects, such as myocarditis, pericarditis, and myopericarditis, are becoming increasingly more common. Our case describes a 64-year-old male who developed chest pain and shortness of breath one week after receiving the Moderna (Cambridge, Massachusetts) COVID-19 mRNA vaccine. He was found to have a large, left-sided pleural effusion and a small pericardial effusion. The patient underwent thoracentesis and video-assisted thoracoscopic procedure with chest tube placement, which drained bloody pleural and pericardial fluid. He was treated with a course of colchicine. Subsequent imaging revealed the resolution of pericardial and pleural effusions, along with the resolution of symptoms.

A Possible Case of Autoimmune Encephalitis After mRNA COVID-19 Booster Vaccine: A Case Report

“…The safety profile of these vaccines needs continuous monitoring. Hence, post-marketing pharmacovigilance remains of vital importance to establish an accurate safety profile of COVID-19 vaccines [ 4 ]. Our patient meets the diagnostic criteria of possible autoimmune encephalitis including rapid onset of behavioral changes and altered mental status, CSF pleocytosis, and reasonable exclusion of other etiologies [ 5 ].…”

Large Hemorrhagic Pericardial Effusion and Cardiac Tamponade Following BNT162b2 (BioNTech/Pfizer) Vaccine

“…6 A second case of hemorrhagic pericardial effusion was reported in a 64-year-old man with chest pain and dyspnea one week following second dose of the Moderna (mRNA-1273) COVID-19 vaccination. 7 The patient's symptoms resolved with pericardiocentesis and colchicine. The differential diagnosis of hemorrhagic pericardial effusion overlaps with serous pericardial effusions, including post-pericardiotomy complications, aortic dissection, uremia, myocardial infarction, trauma, and tuberculosis.…”

“…3 Two prior cases of hemorrhagic pericardial effusion associated with mRNA COVID-19 vaccination are reported, without tamponade. 6,7 A 74-year-old man with a history of alcoholic cirrhosis and hypertension without COVID-19 exposure or other preceding illness, presented with fever, chills, chest pain, and back pain two weeks following sec-ond dose of BNT162b2 (BioNTech/Pfizer) vaccine. 6 Pericardiocentesis and drainage were performed with 560 cc of bloody fluid.…”

“…Hemorrhagic pericardial effusion with cardiac tamponade has also been described as the presentation for COVID-19 infection. 7 Mehmood et al describe a case of hemorrhagic pericardial effusion leading to cardiac tamponade as the initial presentation of lung cancer. 12 Pericarditis associated mRNA vaccinations may be linked to immunogenic, autoimmune, and hormonal pathways.…”

“…1,2 Cardiac tamponade has been reported following mRNAbased COVID-19 vaccination and COVID-19 infection. [3][4][5][6][7][8][9][10] Globally, there have been approximately 596 million cases of COVID-19 and 6.4 million reported deaths as of July 2022. Over 12.6 billion vaccination doses have been provided over 184 countries, which averages to be 161 injections per 100 persons worldwide.…”