Vaccine-derived Yellow Fever in an immunocompromised patient on anti-CD20-antibody therapy and its treatment with Sofosbuvir.

Yellow fever (YF) is a potentially lethal viral hemorrhagic fever that can be prevented with the 17D live attenuated YF vaccine. However, this vaccination can cause severe adverse reactions including vaccine-associated YF. Here, we describe the case of a 32-year-old female who was permanently immunosuppressed with an anti-CD20 antibody due to multiple sclerosis. Following YF vaccination, the patient developed, a variety of symptoms such as febrile temperatures, muscle and joint pain, headaches, and dysuria. A vaccine-associated yellow fever with viremia was diagnosed. To avoid a potentially severe course of the disease, sofosbuvir was used as antiviral treatment followed by the resolution of symptoms and serological response. As travelers with chronic diseases and immunosuppression will increasingly engage in long distance travel, this case demonstrates the importance of assessing patient history prior to life vaccinations and points towards a possible therapeutic approach in those suffering from vaccine associated yellow fever.

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Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tobias Weirauch, Gerrit Burger, Daniel Cadar, Martin Gabriel, Gundolf Schüttfort, Philipp de Leuw, Markus Bickel and Nils Wetzstein have nothing to disclose. Julia Koepsell received speaker fees from Tillotts Pharma GmbH and congress funding from AstraZeneca. Maria Vehreschild received grants from MSD, Heel, Biontech, Roche; consulting fees from MaaT, Tillotts, MSD/Merck, Roche, EUMEDICA; and payments or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from MSD/Merck, 3M, Ferring, Astellas, Uniklinik Karlsruhe, Uniklinik Köln, Akademie für Infektionsmedizin, Klinikum Essen, Pfizer, Universitätsklinikum Heidelberg, Universitätsklinikum Frankfurt, Landesärztekammer Hessen, Janssen, Institute Merieux, Forum für medizinische Fortbildung GmbH, Universitätsklinikum Freiburg, Berliner Dialy Seminar, ADKA, Falk Foundation,St. johannes Hospital, Dialog Service, CED Service, Ärztekammer Niedersachsen, St. Josef Hospital, Limbach Gruppe SE, SUMIT OXFORD Ltd., EUMEDICA Kit Kongress, Tillotts Pharma, Helios Kliniken, Lahn-Dill-Kliniken, GILEAD, Klinikum Leverkusen. Timo Wolf received travel and conference grants as well as fees for lectures from Merck Sharp Dome and Gilead Pharmaceuticals. He serves as speaker of STAKOB and was a consultant for the European expert group on SARS-CoV-2 variants (E03791) (EU commission). None of the COIs are in relation to this work.