Authors
Nazife Duygu Demirbaş, Doğukan Canatar, Dilara Karakuş, Ceren Atasoy Tahtasakal, Okan Derin
Published in
Mikrobiyoloji bulteni. Volume 60. Issue 3. Pages 400-407.
Abstract
The yellow fever vaccine containing the live attenuated 17D strain is one of the most effective methods for preventing yellow fever infection and has long been considered safe. However, rare but serious adverse events such as yellow fever vaccine-associated viscerotropic disease (YEL-AVD) have been reported. YELAVD is a life-threatening clinical condition that can mimic wild-type yellow fever infection, is associated with a high risk of mortality, and may pose diagnostic challenges, particularly in non-endemic regions. A 57-year-old male patient with no underlying comorbidities, history of immunosuppression, or thymic pathology presented with a high fever that began two days after yellow fever vaccination and had persisted for seven days at the time of admission. Physical examination revealed hypotension and jaundice; hemodynamic stability was achieved with intravenous fluid resuscitation. Laboratory findings demonstrated thrombocytopenia and hepatic dysfunction. Infectious etiologies, including malaria, dengue fever, West Nile virus infection, and Crimean-Congo hemorrhagic fever, as well as other possible causes, were comprehensively and systematically excluded; no etiological findings were identified in blood cultures or imaging studies. Although polymerase chain reaction (PCR) testing for yellow fever virus was negative, the presence of two major Brighton Collaboration criteria-hepatic involvement and thrombocytopenia-together with the systematic exclusion of alternative etiologies supported the classification of this case as consistent with level 2 diagnostic certainty for YEL-AVD. The patient fully recovered with supportive treatment without requiring intensive care. To the best of our knowledge, this is the first reported case of YEL-AVD from Türkiye. The increasing number of international travel from non-endemic to endemic regions and the expanding use of vaccination highlight the need for increased clinical awareness of rare but serious adverse events such as YEL-AVD. This case emphasizes the importance of early assessment of vaccination history in the differential diagnosis and underscores the value of case reports in global vaccine safety surveillance.
PMID:
42583857
Bibliographic data and abstract were imported from PubMed on 12 Aug 2026.
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