Healthy Young Woman With Fever and Jaundice

Abstract

Yellow fever vaccine (YFV) can have rare but severe adverse events, including YFV-associated neurologic disease (YEL-AND), YFV-associated viscerotropic disease (YEL-AVD), and anaphylaxis. Risks of YEL-AND and YEL-AVD increase with age. YEL-AND is characterized by encephalitis, meningitis, Guillain-Barré syndrome, or acute disseminated encephalomyelitis within 28 days after vaccination. Meningoencephalitis is the most common manifestation. Diagnosis can be aided by polymerase chain reaction testing of cerebrospinal fluid for YF virus or for antibodies specific to the YF virus. Most patients with YEL-AND recover without residual deficits. Treatment should be chosen based on the presenting syndrome, and a neurologic consultation is warranted.