diphtheria tetanus and pertussis vaccine

Reactions 1459 - 6 Jul 2013

SDiphtheria tetanus and pertussisvaccine

Seizures and encephalopathy in an infant: casereport

A 5-month-old boy developed seizures and encephalopathyafter receiving diphtheria tetanus and pertussis vaccine.

The boy developed seizures and was admitted to hospital3 days after receiving diphtheria tetanus and pertussis vaccine[dosage and route not stated]. The seizures were controlledand he was discharged after 9 days. He was at home for 3 dayswithout treatment and subsequently developed seizures again;he was again admitted and received treatment before beingtransferred to another hospital 16 days after vaccination. Atthat time he was experiencing generalised tonic-clonicseizures 4–5 times per day. He had altered sensorium, and hispupils were constricted and poorly reacting to light. CT andMRI scan of his brain, and EEG were normal.

The boy received midazolam, phenytoin, levetiracetam,phenobarbital, clobazam and subsequently clonazepam. Hisseizures decreased in frequency from day 2 and his last seizureoccurred on day 13. He became fully conscious on day 15. At3-months follow-up, no neurological sequel was observed.

Author comment: "Naranjo’s scale showed that therelationship between diphtheria tetanus and pertussis vaccineand acute encephalopathy was probable. According toBrighton criteria for vaccine-induced encephalopathy, thepresent adverse event was of level 3."Patel KP, et al. Diphtheria, pertussis (whooping cough), and tetanus vaccineinduced recurrent seizures and acute encephalopathy in a pediatric patient: Possiblydue to pertussis fraction. Journal of Pharmacology and Pharmacotherapeutics 3:71-73, No. 1, Jan-Mar 2012. Available from: URL: http://dx.doi.org/10.4103/0976-500X.92514 - India 803089361

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