Case Report: Fatal Viscerotropic Disease in a Young Woman Following Yellow Fever Vaccination

Mariângela Ottoboni Brunaldi Department of Pathology and Forensic Medicine, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;

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René Julias Costa Silva Department of Pathology and Forensic Medicine, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;

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Alexandre Todorovic Fabro Department of Pathology and Forensic Medicine, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;

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Daniel Cardoso de Almeida e Araujo Division of Epidemiological Surveillance, Secretaria Municipal de Saúde, Ribeirão Preto, São Paulo, Brazil;

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Anibal Basile-Filho Division of Intensive Care Medicine, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;

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Maria Auxiliadora-Martins Division of Intensive Care Medicine, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;

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Mayra Gonçalves Menegueti Division of Intensive Care Medicine, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;

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Maria Isabel Beloddi Division of Intensive Care Medicine, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;

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Danillo Lucas Alves Esposito Infectious Diseases Division, Department of Internal Medicine, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil

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Benedito Antônio Lopes da Fonseca Infectious Diseases Division, Department of Internal Medicine, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil

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ABSTRACT.

Yellow fever is a viral hemorrhagic disease, and vaccination is the most effective way to minimize the impact of the disease. Serious adverse events after yellow fever vaccination are rare. We report the case of a young woman with an unusual presentation of yellow fever 17DD vaccine-associated acute viscerotropic disease, with severe hepatic impairment following a long incubation period. She died more than a month after yellow fever vaccination.

Author Notes

Address correspondence to Mariângela Ottoboni Brunaldi, Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Av. dos Bandeirantes 3900, 14049-900 - Ribeirão Preto, São Paulo, Brazil. E-mail: mabrunaldi@fmrp.usp.br

Financial support: This work was supported by São Paulo Research Foundation (FAPESP-N°2003/07959-0).

Authors’ addresses: Mariângela Ottoboni Brunaldi, René Julias Costa Silva, and Alexandre Todorovic Fabro, Department of Pathology and Forensic Medicine, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil, E-mails: mabrunaldi@fmrp.usp.br, renejulias@yahoo.com.br, and fabro@fmrp.usp.br. Daniel Cardoso de Almeida e Araujo, Division of Epidemiological Surveillance, Secretaria Municipal de Saúde, Ribeirão Preto, São Paulo, Brazil, E-mail: dacaraujo@alumni.usp.br. Anibal Basile-Filho, Maria Auxiliadora-Martins, Mayra Gonçalves Menegueti, and Maria Isabel Beloddi, Division of Intensive Care Medicine, Department of Surgery and Anatomy. University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil, E-mails: abasile@fmrp.usp.br, mamartins@hcrp.usp.br, mayramenegueti@usp.br, and bel_ft@yahoo.com.br. Danillo Lucas Alves Esposito and Benedito Antônio Lopes da Fonseca, Infectious Diseases Division, Department of Internal Medicine, University Hospital, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil, E-mails: esposito@usp.br and bfonseca@usp.br.

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