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This is VAERS ID 174865

Case Details

VAERS ID: 174865 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Female  
Location: Texas  
Vaccinated:2001-08-08
Onset:2001-08-12
   Days after vaccination:4
Submitted: 2001-08-22
   Days after onset:10
Entered: 2001-09-04
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0739L / 2 - / SC

Administered by: Private       Purchased by: Other
Symptoms: Brain oedema, Headache, Hernia, Lethargy, Pyrexia, Viral infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2001-08-18
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a demyelinating process as is classically demonstrated in this lesion.
CDC Split Type:

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illness.


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