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This is VAERS ID 164955

Case Details

VAERS ID: 164955 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:1990-02-01
Submitted: 2001-01-15
   Days after onset:4001
Entered: 2001-01-22
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 2 - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Coma, Convulsion, Drug ineffective, Dysarthria, Electroencephalogram abnormal, Encephalitis, HIV infection, Haemoglobin decreased, Leukopenia, Lymphopenia, Muscle twitching, Necrosis, Nervous system disorder, Respiratory distress, Tachypnoea, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Lack of efficacy/effect (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hemophilia A, HIV
Current Illness:
Preexisting Conditions: Hemophilia A; human immunodeficiency virus infection
Allergies:
Diagnostic Lab Data: CSF and CT of head-were nml; EEG-showed right frontal slowing with spike discharges centrally; CBC-nml; CXR-nml; lab-showed evidence of the syndrome of inappropriate secretion of adrenocorticotropic hormone was found; Titers of measles antibody at this time were undetectable; autopsy-the brain weighed 1.540 g (expected weight, 1.350 g) and its gross characteristics were nml; Focal acute neuronal necrosis was evident in the dentate nucleus
CDC Split Type: WAES01010267

Write-up: In 4/90, 11 days post vax, the pt experienced recurrent focal seizures. At the time his HIV infection was diagnosed in 10/85, blood analysis consistently revealed leukopenia, mild thrombocytopenia and hemoglobin concentrations of 11.2 to 13.6, lymphocyte counts were around 200-300, CD4 to CD8 ratios of 0.2-0.47. In 10/89, therapy with zidovudine was initiated. The pt had no symptoms related to HIV infection or zidovudine therapy. Although he had received the measles vaccine in 1973 at the age of 3 and a dose of MMR in 1976 at the age of 7, the pt was admitted to the hospital for three days in 2/90 with uncomplicated measles. Tachypnea and respiratory distress responded promptly to therapy with oxygen and aerosolized ribavirin. The pt responded well until two months later, when he presented after two days of recurrent right arm twitches without fever. Physical exam revealed only continuous fine twitches of th right arm. CSF analysis and computed tomography of the head gave normal results, electroencephalography, however, showed right frontal slowing with spike discharges centrally, persisted despite therapeutic anticonvulsant concentrations in serum. the pt was admitted 11 days after the onset of seizures for further diagnostic evaluation. At the time of admission, he was conscious and afebrile. He had right-arm and right-leg twitching but was able to walk. His mental status and the results of motor and sensory examination were normal. Although the latter condition responded to the fluid restriction, the pt developed slurred speech and gradually became unresponsive requiring endotracheal intubation. A 10 day course of IV therapy was given. The pt remained comatose, experiencing continuous focal seizures that could not be controlled with anticonvulsant agents. Neurological and electroencepahlographic exam on day 24 of hospitalization indicated brain death. Mechanical ventilation was discontinued on day 30. The cause of death was subacute measles encephalitis.


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