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Post-Vaccinial Encephalitis:
Diagnosis
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A variety of encephalitic syndromes can mimic those attributed to vaccination. The possible causes are numerous and include, but are not limited to, Epstein-Barr Virus (EBV), herpes viruses, enteroviruses, measles, mumps, Mycoplasma pneumoniae, varicella-zoster virus, and arboviruses. In addition a variety of encephalopathies can produce identical symptoms.
Studies should be undertaken to rule out other causes, as this diagnosis is ultimately one of exclusion. Polymerase chain reaction (PCR) testing of spinal fluid for a range of agents normally causing meningo-encephalitis should be performed. Bacterial infection should also be ruled out by examination of the cerebrospinal fluid, and other appropriate cultures. The peripheral white blood cell count and in the CSF are non-specific, showing an increase in mononuclear cells. Cerebrospinal fluid protein and glucose may be slightly elevated.
Typically, temporal association with vaccination (10-14 days to onset on the average) and meningo-encephalitic symptoms suggest this entity.
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