Wednesday, November 26, 2008

A Chicken Ain't Nothing But a Bird

Happy Thanksgiving! I was again hard-pressed to come up with a somewhat Thanksgiving related case. This one comes from a Warren Levinson lecture one year ago and I have to give thanks to him for the idea.

A medical student with known egg allergy presents with the following after receiving a vaccine.

Challenge: What vaccine was the culprit and why?

Related Questions:
1. What's shown in the image?

Image shown under fair use.

3 comments:

Alex said...

when i took a flu vaccine, they asked if i had an egg allergy

Stephanie said...

influenza vaccine, grown in chicken eggs during processing, urticaria

Craig Chen said...

:)
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A Chicken Ain't Nothing But a Bird

The image shows urticaria, an eruption of transient pruritic elevated papules and plaques often with erythematous, sharply-defined borders and pale centers (wheals). It suggests a hypersensitivity reaction. Most likely this was due to an influenza vaccine which is grown in chick extra-embryonic allantoic fluid. Individuals with an egg allergy should be skin-tested prior to administration. You would also get full credit for "yellow fever vaccine" since that also has micrograms of egg protein because it is grown in chick embryos. According to UpToDate, measles, mumps, and rabies vaccines can be administered to egg-allergic patients.

Sources: UpToDate; missinglink.ucsf.edu.