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Published in: BMC Infectious Diseases 1/2022

Open Access 01-12-2022 | Herpes Virus | Case report

Herpes simplex encephalitis following ChAdOx1 nCoV-19 vaccination: a case report and review of the literature

Authors: Mohammadreza Moslemi, Mohammadreza Ardalan, Morteza Haramshahi, Homa Mirzaei, Sahba Khosousi Sani, Ramtin Dastgir, Nima Dastgir

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

Background

Ever since the administration of early doses of COVID-19 vaccines, instances of adverse effects have been reported. Viral infections, specifically herpes simplex reinfection and coinfections, have been reported following administration of different types of vaccines. To our knowledge, there have not been any reports of herpes simplex encephalitis following administration of any type of COVID-19 vaccine to date.

Case presentation

In this article intends to report a case of herpes simplex encephalitis in a 27-year-old male patient who was vaccinated with the ChAdOx1 nCoV-19 vaccine.

Conclusions

Our study suggests a possible but very rare side effect of ChAdOx1 nCoV-19 vaccine, which requires immediate medical attention and can lead to devastating consequences if left undiagnosed and untreated.
Literature
1.
go back to reference Coronavirus disease (COVID-19). Vaccines [Internet]. Who.int. [cited 2021 Nov 6]. Available from: https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-vaccines?adgroupsurvey={adgroupsurvey}&gclid=CjwKCAjwz5iMBhAEEiwAMEAw%20GHUvWO3dmENLKhv5uu5F_GbqqKLr6MbJhSfv1TCi2TkuzxiHllo_OxoCcgQAvD_%20BwE. Coronavirus disease (COVID-19). Vaccines [Internet]. Who.int. [cited 2021 Nov 6]. Available from: https://​www.​who.​int/​news-room/​questions-and-answers/​item/​coronavirus-disease-(covid-19)-vaccines?adgroupsurvey={adgroupsurvey}&gclid=CjwKCAjwz5iMBhAEEiwAMEAw%20GHUvWO3dmENLKhv5uu5F_GbqqKLr6MbJhSfv1TCi2TkuzxiHllo_OxoCcgQAvD_%20BwE.
3.
go back to reference Voysey M, Clemens SAC, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021;397(10269):99–111.CrossRef Voysey M, Clemens SAC, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021;397(10269):99–111.CrossRef
4.
go back to reference Le Balc’h P, Pinceaux K, Pronier C, Seguin P, Tadié J-M, Reizine F. Herpes simplex virus and cytomegalovirus reactivations among severe COVID-19 patients. Crit Care. 2020;24(1):530.CrossRef Le Balc’h P, Pinceaux K, Pronier C, Seguin P, Tadié J-M, Reizine F. Herpes simplex virus and cytomegalovirus reactivations among severe COVID-19 patients. Crit Care. 2020;24(1):530.CrossRef
5.
go back to reference van Dam CS, Lede I, Schaar J, Al-Dulaimy M, Rösken R, Smits M. Herpes zoster after COVID vaccination. Int J Infect Dis. 2021;111:169–71.CrossRef van Dam CS, Lede I, Schaar J, Al-Dulaimy M, Rösken R, Smits M. Herpes zoster after COVID vaccination. Int J Infect Dis. 2021;111:169–71.CrossRef
6.
go back to reference Ferreira ACA, de Romão F, Macedo TT, Pupe YS, Nascimento C. Fellow of the American Academy of Neurology (FAAN). COVID-19 and herpes zoster co-infection presenting with trigeminal neuropathy. Eur J Neurol. 2020;27(9):1748–50.CrossRef Ferreira ACA, de Romão F, Macedo TT, Pupe YS, Nascimento C. Fellow of the American Academy of Neurology (FAAN). COVID-19 and herpes zoster co-infection presenting with trigeminal neuropathy. Eur J Neurol. 2020;27(9):1748–50.CrossRef
7.
go back to reference Chiu H-H, Wei K-C, Chen A, Wang W-H. Herpes zoster following COVID-19 vaccine: report of 3 cases. QJM. 2021;114(7):531–2.CrossRef Chiu H-H, Wei K-C, Chen A, Wang W-H. Herpes zoster following COVID-19 vaccine: report of 3 cases. QJM. 2021;114(7):531–2.CrossRef
8.
go back to reference Walter R, Hartmann K, Fleisch F, Reinhart WH, Kuhn M. Reactivation of herpesvirus infections after vaccinations? Lancet. 1999;353(9155):810.CrossRef Walter R, Hartmann K, Fleisch F, Reinhart WH, Kuhn M. Reactivation of herpesvirus infections after vaccinations? Lancet. 1999;353(9155):810.CrossRef
9.
go back to reference Venkatesan A, Tunkel AR, Bloch KC, Lauring AS, Sejvar J, Bitnun A, et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis. 2013;57(8):1114–28.CrossRef Venkatesan A, Tunkel AR, Bloch KC, Lauring AS, Sejvar J, Bitnun A, et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis. 2013;57(8):1114–28.CrossRef
10.
go back to reference Venkatesan A. Epidemiology and outcomes of acute encephalitis. Curr Opin Neurol. 2015;28(3):277–82.CrossRef Venkatesan A. Epidemiology and outcomes of acute encephalitis. Curr Opin Neurol. 2015;28(3):277–82.CrossRef
11.
go back to reference Shieh MT, Spear PG. Herpesvirus-induced cell fusion that is dependent on cell surface heparan sulfate or soluble heparin. J Virol. 1994;68(2):1224–8.CrossRef Shieh MT, Spear PG. Herpesvirus-induced cell fusion that is dependent on cell surface heparan sulfate or soluble heparin. J Virol. 1994;68(2):1224–8.CrossRef
12.
go back to reference Mata M, Zhang M, Hu X, Fink DJ. HveC (nectin-1) is expressed at high levels in sensory neurons, but not in motor neurons, of the rat peripheral nervous system. J Neurovirol. 2001;7(5):476–80.CrossRef Mata M, Zhang M, Hu X, Fink DJ. HveC (nectin-1) is expressed at high levels in sensory neurons, but not in motor neurons, of the rat peripheral nervous system. J Neurovirol. 2001;7(5):476–80.CrossRef
13.
go back to reference Shukla ND, Tiwari V, Valyi-Nagy T. Nectin-1-specific entry of herpes simplex virus 1 is sufficient for infection of the cornea and viral spread to the trigeminal ganglia. Mol Vis. 2012;18:2711–6.PubMedPubMedCentral Shukla ND, Tiwari V, Valyi-Nagy T. Nectin-1-specific entry of herpes simplex virus 1 is sufficient for infection of the cornea and viral spread to the trigeminal ganglia. Mol Vis. 2012;18:2711–6.PubMedPubMedCentral
14.
go back to reference Mori I, Nishiyama Y, Yokochi T, Kimura Y. Olfactory transmission of neurotropic viruses. J Neurovirol. 2005;11(2):129–37.CrossRef Mori I, Nishiyama Y, Yokochi T, Kimura Y. Olfactory transmission of neurotropic viruses. J Neurovirol. 2005;11(2):129–37.CrossRef
15.
go back to reference Jennische E, Eriksson CE, Lange S, Trybala E, Bergström T. The anterior commissure is a pathway for contralateral spread of herpes simplex virus type 1 after olfactory tract infection. J Neurovirol. 2015;21(2):129–47.CrossRef Jennische E, Eriksson CE, Lange S, Trybala E, Bergström T. The anterior commissure is a pathway for contralateral spread of herpes simplex virus type 1 after olfactory tract infection. J Neurovirol. 2015;21(2):129–47.CrossRef
16.
go back to reference Rabinstein AA. Herpes virus encephalitis in adults. Neurol Clin. 2017;35(4):695–705.CrossRef Rabinstein AA. Herpes virus encephalitis in adults. Neurol Clin. 2017;35(4):695–705.CrossRef
17.
go back to reference Fernandez-Nieto D, Ortega-Quijano D, Suarez-Valle A, Burgos-Blasco P, Jimenez-Cauhe J, Fernandez-Guarino M. Comment on:“To consider varicella-like exanthem associated with COVID-19, virus varicella zoster and virus herpes simplex must be ruled out. Characterization of herpetic lesions in hospitalized COVID-19 patients. J Am Acad Dermatol. 2020;83:e257-9.CrossRef Fernandez-Nieto D, Ortega-Quijano D, Suarez-Valle A, Burgos-Blasco P, Jimenez-Cauhe J, Fernandez-Guarino M. Comment on:“To consider varicella-like exanthem associated with COVID-19, virus varicella zoster and virus herpes simplex must be ruled out. Characterization of herpetic lesions in hospitalized COVID-19 patients. J Am Acad Dermatol. 2020;83:e257-9.CrossRef
18.
go back to reference Eagle RA, Jafferji I, Barrow AD. Beyond stressed self: evidence for NKG2D ligand expression on healthy cells. Curr Immunol Rev. 2009;5(1):22–34.CrossRef Eagle RA, Jafferji I, Barrow AD. Beyond stressed self: evidence for NKG2D ligand expression on healthy cells. Curr Immunol Rev. 2009;5(1):22–34.CrossRef
19.
go back to reference Schmiedel D, Mandelboim O. Disarming cellular alarm systems-manipulation of stress-induced NKG2D ligands by human herpesviruses. Front Immunol. 2017;8:390.CrossRef Schmiedel D, Mandelboim O. Disarming cellular alarm systems-manipulation of stress-induced NKG2D ligands by human herpesviruses. Front Immunol. 2017;8:390.CrossRef
20.
go back to reference Nausch N, Cerwenka A. NKG2D ligands in tumor immunity. Oncogene. 2008;27(45):5944–58.CrossRef Nausch N, Cerwenka A. NKG2D ligands in tumor immunity. Oncogene. 2008;27(45):5944–58.CrossRef
21.
go back to reference González S, López-Soto A, Suarez-Alvarez B, López-Vázquez A, López-Larrea C. NKG2D ligands: key targets of the immune response. Trends Immunol. 2008;29(8):397–403.CrossRef González S, López-Soto A, Suarez-Alvarez B, López-Vázquez A, López-Larrea C. NKG2D ligands: key targets of the immune response. Trends Immunol. 2008;29(8):397–403.CrossRef
22.
go back to reference Ewer KJ, Barrett JR, Belij-Rammerstorfer S, Sharpe H, Makinson R, Morter R, et al. T cell and antibody responses induced by a single dose of ChAdOx1 nCoV-19 (AZD1222) vaccine in a phase 1/2 clinical trial. Nat Med. 2021;27(2):270–8.CrossRef Ewer KJ, Barrett JR, Belij-Rammerstorfer S, Sharpe H, Makinson R, Morter R, et al. T cell and antibody responses induced by a single dose of ChAdOx1 nCoV-19 (AZD1222) vaccine in a phase 1/2 clinical trial. Nat Med. 2021;27(2):270–8.CrossRef
23.
go back to reference Tartari F, Spadotto A, Zengarini C, Zanoni R, Guglielmo A, Adorno A, et al. Herpes zoster in COVID-19-positive patients. Int J Dermatol. 2020;59(8):1028–9.CrossRef Tartari F, Spadotto A, Zengarini C, Zanoni R, Guglielmo A, Adorno A, et al. Herpes zoster in COVID-19-positive patients. Int J Dermatol. 2020;59(8):1028–9.CrossRef
24.
go back to reference Tessas I, Kluger N. Ipsilateral herpes zoster after the first dose of BNT162b2 mRNA COVID-19 vaccine. J Eur Acad Dermatol Venereol. 2021;35(10):e620-2.CrossRef Tessas I, Kluger N. Ipsilateral herpes zoster after the first dose of BNT162b2 mRNA COVID-19 vaccine. J Eur Acad Dermatol Venereol. 2021;35(10):e620-2.CrossRef
25.
go back to reference Eid E, Abdullah L, Kurban M, Abbas O. Herpes zoster emergence following mRNA COVID-19 vaccine. J Med Virol. 2021;93(9):5231–2.CrossRef Eid E, Abdullah L, Kurban M, Abbas O. Herpes zoster emergence following mRNA COVID-19 vaccine. J Med Virol. 2021;93(9):5231–2.CrossRef
26.
go back to reference Bostan E, Yalici-Armagan B. Herpes zoster following inactivated COVID-19 vaccine: a coexistence or coincidence? J Cosmet Dermatol. 2021;20(6):1566–7.CrossRef Bostan E, Yalici-Armagan B. Herpes zoster following inactivated COVID-19 vaccine: a coexistence or coincidence? J Cosmet Dermatol. 2021;20(6):1566–7.CrossRef
27.
go back to reference Palanivel JA. Herpes zoster after COVID-19 vaccination—can the vaccine reactivate latent zoster virus? J Cosmet Dermatol. 2021;20(11):3376–7.CrossRef Palanivel JA. Herpes zoster after COVID-19 vaccination—can the vaccine reactivate latent zoster virus? J Cosmet Dermatol. 2021;20(11):3376–7.CrossRef
28.
go back to reference Arora P, Sardana K, Mathachan SR, Malhotra P. Herpes zoster after inactivated COVID-19 vaccine: a cutaneous adverse effect of the vaccine. J Cosmet Dermatol. 2021;20(11):3389–90.CrossRef Arora P, Sardana K, Mathachan SR, Malhotra P. Herpes zoster after inactivated COVID-19 vaccine: a cutaneous adverse effect of the vaccine. J Cosmet Dermatol. 2021;20(11):3389–90.CrossRef
29.
go back to reference Ardalan M, Moslemi H, Shafiei S, Tabrizi R, Moselmi M. Herpes-like skin lesion after AstraZeneca vaccination for COVID-19: a case report. Clin Case Rep. 2021;9(10):e04883.CrossRef Ardalan M, Moslemi H, Shafiei S, Tabrizi R, Moselmi M. Herpes-like skin lesion after AstraZeneca vaccination for COVID-19: a case report. Clin Case Rep. 2021;9(10):e04883.CrossRef
30.
go back to reference Zuhorn F, Graf T, Klingebiel R, Schäbitz W-R, Rogalewski A. Postvaccinal encephalitis after ChAdOx1 nCov-19. Ann Neurol. 2021;90(3):506–11.CrossRef Zuhorn F, Graf T, Klingebiel R, Schäbitz W-R, Rogalewski A. Postvaccinal encephalitis after ChAdOx1 nCov-19. Ann Neurol. 2021;90(3):506–11.CrossRef
31.
go back to reference Greene TT, Tokuyama M, Knudsen GM, Kunz M, Lin J, Greninger AL, et al. A Herpesviral induction of RAE-1 NKG2D ligand expression occurs through release of HDAC mediated repression. Elife. 2016;5:e14749.CrossRef Greene TT, Tokuyama M, Knudsen GM, Kunz M, Lin J, Greninger AL, et al. A Herpesviral induction of RAE-1 NKG2D ligand expression occurs through release of HDAC mediated repression. Elife. 2016;5:e14749.CrossRef
Metadata
Title
Herpes simplex encephalitis following ChAdOx1 nCoV-19 vaccination: a case report and review of the literature
Authors
Mohammadreza Moslemi
Mohammadreza Ardalan
Morteza Haramshahi
Homa Mirzaei
Sahba Khosousi Sani
Ramtin Dastgir
Nima Dastgir
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07186-9

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