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This is VAERS ID 241136

Case Details

VAERS ID: 241136 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Male  
Location: Michigan  
Vaccinated:2005-06-23
Onset:2005-06-26
   Days after vaccination:3
Submitted: 2005-07-08
   Days after onset:12
Entered: 2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 1 LA / IM

Administered by: Public       Purchased by: Private
Symptoms: Abnormal behaviour, CSF test abnormal, Diarrhoea, Fatigue, Headache, Hypoaesthesia, Laboratory test abnormal, Myasthenic syndrome, Nausea, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Malignancy related conditions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Information received from medical records states white count increased, lab tests abnormal, cerebral spinal fluid abnormal.
CDC Split Type:

Write-up: Father states pt c/o headache, nausea and vomiting, and diarrhea 6/26/2005. Father states headache persisted but nausea, vomiting, and diarrhea stopped 7/04/2005 and then on 7/04/2005 left arm and entire left side of body went numb. Hospitalized for 3 days. Father called health department 7/08/2005 to report this event. States son is still very fatigued and "not himself". Information from medical records state myasthenia.


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