Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 27, Number 6—June 2021
CME ACTIVITY - Research

Neurologic Disease after Yellow Fever Vaccination, São Paulo, Brazil, 2017–2018

Ana Freitas Ribeiro1, Bruno Fukelmann Guedes1Comments to Author , Jamal M.A.H. Sulleiman, Francisco Tomaz Meneses de Oliveira, Izabel Oliva Marcilio de Souza, Juliana Silva Nogueira, Rosa Maria Nascimento Marcusso, Eder Gatti Fernandes, Guilherme Sciascia do Olival, Pedro Henrique Fonseca Moreira de Figueiredo, Ana Paula Rocha Veiga, Flávia Esper Dahy, Natália Nasser Ximenes, Lecio Figueira Pinto, José Ernesto Vidal, and Augusto Cesar Penalva de Oliveira
Author affiliations: Universidade Nove de Julho, São Paulo, Brazil (A.F. Ribeiro); Instituto de Infectologia Emílio Ribas, São Paulo (A.F. Ribeiro, J.M.A.H. Sulleiman, R.M. Nascimento Marcusso, G. Sciascia do Olival, A.P. Rocha Veiga, F. Esper Dahy, J.E. Vidal, A.C. Penalva de Oliveira); Hospital das Clínicas, Universidade de São Paulo, São Paulo (B.F. Guedes, I.O. Marcilio de Souza, P.H.F. Moreira de Figueiredo, N. Nasser Ximenes, L. Figueira Pinto, J. Ernesto Vidal); Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo (F.T. Meneses de Oliveira); Instituto Adolfo Lutz, São Paulo (J. Silva Nogueira); Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, São Paulo (E. Gatti Fernandes)

Main Article

Table 2

Laboratory, neurophysiologic, and imaging characteristics for 42 patients with suspect YEL-AND, according to classification with the Brighton Collaboration criteria, São Paulo, Brazil, 2017–2018*

Variable Aseptic meningitis, n = 24 Encephalitis, n = 8 Guillain-Barré syndrome, n = 3‡ Myelitis, n = 2‡ ADEM, n = 2‡ Unclassified,† n = 3‡
CSF parameters§
Leukocytes >5, no. (%) 24 (100) 7 (87.5) 1 (33) 0 1 (50) 1 (33)
Leukocytes, total/mm3, median (IQR) [range] 76.50 (53–207.5) 30 (13–70) 1 [0–32] 1 [0–2] 4.5 [2–7] 2 [1–12]
Lymphocytes, median (IQR) [range] 73 (65.5–88.0) 85 (71–93) 51.5 [3 –71] 75 [75–75] 79,5 [79–80] 80 [73–92]
Neutrophils, median (IQR) [range] 10 (3.5–25.0) 3 (0.5–6.0) 23.5 [13–34] 16 [16–16] 19.5 [19–20] 2 [1–3]
Erythrocytes, total/mm3, median (IQR) [range] 2 (1–12) 5.5 (1–640.50) 302 [249–355] 26 [1–52] 985.5 [131–1,840] 0 [0–3]
Total protein, mg/dL, median (IQR) [range] 53.5 (48–71.5) 60 (47.5–67) 53 [31–66] 27.5 [23–32] 61 [41 – 81] 46 [26–51]
Total glucose, mg/dL, median (IQR) [range] 60 (52.5–64.5) 66 (54.5–92.5) 60.5 [50–71] 72 [66–78] 62.5 [54–71]
MRI findings, no. cases Leptomeningeal enhancement, 1; unremarkable, 3 Leptomeningeal enhancement, 1; unremarkable, 5 Facial nerve enhancement, 1; unremarkable, 1 Longitudinally extensive myelitis,1; partial myelitis, 1 White matter abnormalities and extensive myelitis,1; brainstem and cerebellar peduncles abnormalities, 1 Bilateral optic nerve abnormalities,1; unremarkable, 1
EEG/EMG findings, no. cases EEG: disorganized background, 2; unremarkable, 2 EEG: disorganized background, 6 EMG: AMAN, 1 ND ND ND

*ADEM, acute disseminated encephalomyelitis; AMAN, axonal motor polyneuropathy; CSF, cerebrospinal fluid; EEG, electroencephalography; EMG, electromyography; IQR, interquartile range; ND, not done; YF, yellow fever.
†Includes 1 case of ataxia, 1 of opsoclonus-myoclonus-ataxia, and 1 of optic neuritis.
‡In groups with <5 cases, range was substituted for IQR.
§All patients underwent lumbar puncture and CSF analysis.

Main Article

1These authors contributed equally to this article.

Page created: April 12, 2021
Page updated: May 18, 2021
Page reviewed: May 18, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external