SHM Converge Scientific Abstract ePoster Gallery-A Case of Ebv Reactivation From the Pfizer-Biontech Covid-19 Vaccine

Pdf Summary

This case report describes a 57-year-old woman with no significant past medical history who developed fever, malaise, painful diffuse lymphadenopathy, and palpitations about one month after receiving her second Pfizer-BioNTech COVID-19 vaccine dose. On exam, she was tachycardic and anxious with cervical and axillary lymphadenopathy. Initial testing showed marked inflammation, including elevated white blood cell count, ferritin, CRP, and CD25. CT imaging revealed extensive thoracic, retroperitoneal, and inguinal lymphadenopathy with mild splenomegaly, raising concern for a lymphoproliferative disorder.<br /><br />A broad infectious and malignancy workup was performed. Lymph node biopsy was negative for lymphoma but positive for EBV, and EBV PCR was also positive. Other infectious studies, including COVID-19, blood and respiratory cultures, HIV, hepatitis, TB, fungal, parasitic, and atypical organism testing, were negative. After empiric broad-spectrum antibiotics were stopped, she was diagnosed with disseminated Epstein-Barr virus reactivation with reactive lymphadenopathy, thought to be related to immune reconstitution syndrome after vaccination. She improved significantly after treatment with high-dose steroids followed by a one-week taper, with near-complete symptom resolution and normalization of inflammatory markers.<br /><br />The authors discuss that the Pfizer-BioNTech vaccine uses mRNA to stimulate immunity against SARS-CoV-2 spike protein. They propose that vaccine-induced immune changes may, in rare cases, contribute to herpesvirus reactivation such as EBV, possibly through alterations in NK and T-cell populations, especially CD8 cells. The report emphasizes that while vaccination remains important, unusual post-vaccine infectious complications may warrant further study.

Asset Subtitle

Valerie Jaroenpuntaruk

Meta Tag

Author List Jamie Sturgill, Parijat Sen, Said Chaaban, Valerie Jaroenpuntaruk

Category Clinical Vignettes

Concept Pfizer-BioNTech COVID-19 Vaccine

Concept Epstein-Barr Virus Reactivation

Concept Vaccine Side Effect

Concept Infectious Reactivation

Concept Epstein-Barr virus infectious mononucleosis

Distinguished Non-Finalist

Presenter Organization University of Kentucky

Presenting Author Valerie Jaroenpuntaruk

Track Adult

Keywords

Epstein-Barr virus

EBV reactivation

Pfizer-BioNTech vaccine

COVID-19 vaccination

reactive lymphadenopathy

immune reconstitution syndrome

lymphadenopathy

high-dose steroids

inflammatory markers

case report

Pfizer-BioNTech COVID-19 Vaccine

Epstein-Barr Virus Reactivation

Vaccine Side Effect

Infectious Reactivation

Epstein-Barr virus infectious mononucleosis