Neuritis of the optic nerve after vaccinations against hepatitis A, hepatitis B and yellow fever

Background: Vaccinations are preventive measures against serious infections . In relation to the number of vaccinations per year, the incidence of seve re complications is extremely low. Patient: Two weeks after vaccinations against hepatitis; A, hepatitis B and yellow fever in preparation for a trip to Africa a 21-year-old woman exper ienced an acute and irreversible loss of vision to 0,05 and nasal visual fi eld defect in the left eye. Whereas vision acuity did not recover the scoto ma disappeared within 6 weeks. Cerebrospinal fluid showed a lymphocytic ple ocytosis. Oligoglonale bands were absent. Pathological parameters were not presented in the serum. The MRI showed a hyperintense thickening of optic n erve,as well as a hyperintense focus in right temporal side using the T2W-S equence. Conclusion: Only few cases have been reported with neurological complicatio ns, such as encephalitis, following vaccinations each of the above mentione d. As no other causes for the inflammation were found, the optic nerve invo lvement must have been caused by the vaccination. Which of the three vaccin ations caused encephalitis can not be classified.