Acute disseminated encephalomyelitis in an elderly patient following pneumococcal vaccination with extremely high cerebrospinal fluid interleukin‐6

Abstract Background Postvaccination acute disseminated encephalomyelitis (ADEM) may develop 2–30 days after vaccination. However, ADEM following pneumococcal vaccination has never been reported. Case presentation We report a 73‐year‐old woman with She developed fever and consciousness disturbance 17 the second administration of 23‐valent polysaccharide vaccine (PPSV23). Head magnetic resonance imaging (MRI) revealed numerous T2‐high lesions, mainly involving cerebral cerebellar white matter brainstem. Cerebrospinal fluid examination showed polymorphonuclear pleocytosis markedly elevated interleukin‐6 (58,400 pg/ml). Her symptoms MRI lesions were promptly resolved by steroid pulse therapy, no relapse. Conclusion Although PPSV23 is recommended for elderly individuals, this case highlights risk caused unexpected immune activation repeated vaccine.