{"doi":"10.3390/v13112286","title":"Meningitis Caused by the Live Varicella Vaccine Virus: Metagenomic Next Generation Sequencing, Immunology Exome Sequencing and Cytokine Multiplex Profiling","abstract":"Varicella vaccine meningitis is an uncommon delayed adverse event of vaccination. Varicella vaccine meningitis has been diagnosed in 12 children, of whom 3 were immunocompromised. We now report two additional cases of vaccine meningitis in twice-immunized immunocompetent children and we perform further testing on a prior third case. We used three methods to diagnose or investigate cases of varicella vaccine meningitis, none of which have been used previously on this disease. These include metagenomic next-generation sequencing and cytokine multiplex profiling of cerebrospinal fluid and immunology exome analysis of white blood cells. In one new case, the diagnosis was confirmed by metagenomic next-generation sequencing of cerebrospinal fluid. Both varicella vaccine virus and human herpesvirus 7 DNA were detected. We performed cytokine multiplex profiling on the cerebrospinal fluid of two cases and found ten elevated biomarkers: interferon gamma, interleukins IL-1RA, IL-6, IL-8, IL-10, IL-17F, chemokines CXCL-9, CXCL-10, CCL-2, and G-CSF. In a second new case, we performed immunology exome sequencing on a panel of 356 genes, but no errors were found. After a review of all 14 cases, we concluded that (i) there is no common explanation for this adverse event, but (ii) ingestion of an oral corticosteroid burst 3-4 weeks before onset of vaccine meningitis may be a risk factor in some cases.","journal":"Viruses","year":2021,"id":164746,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":38,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9574,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":109296,"name":"Michael R. Wilson","orcid":"0000-0002-8705-5084","position":1,"is_corresponding":false},{"id":686864,"name":"Gaud Catho","orcid":"0000-0002-4948-0944","position":2,"is_corresponding":false},{"id":686865,"name":"Géraldine Blanchard‐Rohner","orcid":"0000-0002-9974-2172","position":3,"is_corresponding":false},{"id":271948,"name":"Nicoline Schiess","orcid":"0000-0002-0121-8453","position":4,"is_corresponding":false},{"id":406566,"name":"Randall J. Cohrs","orcid":"0000-0002-2383-4046","position":5,"is_corresponding":false},{"id":686866,"name":"David Boutolleau","orcid":"0000-0001-9401-4662","position":6,"is_corresponding":false},{"id":615413,"name":"Sonia Burrel","orcid":"0000-0002-7783-2601","position":7,"is_corresponding":false},{"id":686867,"name":"Tetsushi Yoshikawa","orcid":"0000-0002-2847-7682","position":8,"is_corresponding":false},{"id":624011,"name":"Anne E. Wapniarski","orcid":"0000-0001-9937-2442","position":9,"is_corresponding":false},{"id":496430,"name":"Ethan H. Heusel","orcid":null,"position":10,"is_corresponding":false},{"id":407986,"name":"John E. Carpenter","orcid":null,"position":11,"is_corresponding":false},{"id":407985,"name":"Wallen Jackson","orcid":null,"position":12,"is_corresponding":false},{"id":686868,"name":"Bradley Ford","orcid":"0000-0002-7871-7955","position":13,"is_corresponding":false},{"id":406568,"name":"Charles Grose","orcid":"0000-0001-6884-6668","position":14,"is_corresponding":false},{"id":392076,"name":"Prashanth Ramachandran","orcid":"0000-0001-8464-1355","position":0,"is_corresponding":true}],"reference_count":61,"raw_metadata":null,"created_at":"2026-07-18T23:45:32.226038Z","pmid":"34835092","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}