Reply: Aseptic Meningitis and mRNA Coronavirus Disease 2019 Vaccine.

Dear Editor:

We appreciate the interesting and insightful comments made by Mungmunpuntipantip [1] to the recently published case report in the March 2022 issue of Infection & Chemotherapy [2]. Many cases have been reported about the neurologic adverse events such as fatigue, headache, myelitis, Guillain-Barré syndrome, meningitis-retention syndrome, encephalitis and seizure following coronavirus disease 2019 (COVID-19) vaccination [345]. Five aseptic meningitis cases (including our case) were reported [2678].

In our case, the patient is a healthy male. He doesn’t have any underlying medical problem. He has not been involved in any adverse events after being immunized until this time. He had no overseas travel history. His cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis. Most aseptic meningitis has been treated with a conservative approach. But, our case was treated with methylprednisolone for 3 days.

Mungmunpuntipantip pointed out that the patient’s immune and neurological state prior to inoculation. Our case did not have any immunologic and neurologic problems prior to this event. And he had not experienced any immunologic and neurologic events after previous immunization. Mungmunpuntipantip also mentioned the possibility of aseptic meningitis due to Dengue virus infection in our case. I agree with his opinion. Dengue virus infection can cause aseptic meningitis. Cases of Dengue fever in Korea without overseas travel history are very rare. In particular, in the case of Jeju Island, where the patient resides, there has never been a single case when looking at national statistics for the past 20 years [9]. In our case, even though he had not been checked by laboratory tests in serum and CSF about dengue virus infection. We thought he would be negative because he has not traveled abroad.

It is considered that the neurologic adverse events after COVID-19 vaccination will continue to occur. It is hoped that additional studies and international exchanges on neurologic adverse events occurring after COVID-19 vaccination will be an ongoing process.