| VAERS ID: |
25431 (history) |
| Form: |
Version 1.0 |
| Age: |
1.3 |
| Gender: |
Female |
| Location: |
Illinois |
| Vaccinated: | 1990-06-05 |
| Onset: | 1990-06-05 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-07-09 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1388R / UNK |
- / SC |
Administered by: Private Purchased by: Private
Symptoms: Convulsion,
Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LUMBAR PUNCTURE NEGATIVE ,CTSCAN HEAD- NEGATIVE, UBC 4,300
CDC Split Type:
Write-up: 6 HRS AFTER VACCINE, FEVER AND SEIZURE(LEFT FOCAL SEIZURE) |
