Eosinophilic-lymphocytic myocarditis after smallpox vaccination.

Murphy, Joseph G; Wright, R Scott; Bruce, G Keith; Baddour, Larry M; Farrell, Michael A; Edwards, William D; Kita, Hirohito; Cooper, Leslie T · Lancet · 2003

case_report · Level V

Where this comes from

Abstract

Smallpox is an eradicated viral disease that has re-emerged as a potential bioterrorism threat. Smallpox vaccination was historically the most effective defence measure against wild smallpox virus. The risk of myopericarditis after vaccination might limit this option. We report a case of biopsy-proven eosinophilic-lymphocytic myocarditis diagnosed in vivo with histological evidence for eosinophil-mediated cardiac myocyte necrosis shortly after smallpox vaccination. Furthermore, we report a beneficial haemodynamic response to high-dose corticosteroids. A better understanding of the aberrant immune mechanism of myocyte injury after smallpox vaccination might improve the risk/benefit assessment for people considering smallpox vaccination and better smallpox vaccines in the future.

Medical subject headings