VAERS ID: |
25550 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Colorado |
Vaccinated: | 1989-08-18 |
Onset: | 1989-08-18 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-18 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
0584E / UNK |
- / IM |
Administered by: Private Purchased by: Unknown 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: CDC Split Type:
Write-up: 3 min febrile convulsion in assoc./w fever to 105 F within 12 hrs of receving DTP. Was evaluated @ Hospital ER- full septic W/U; neg C.P.(/), all results neg. observed overnight- no sequele |