| VAERS ID: |
25619 (history) |
| Form: |
Version 1.0 |
| Age: |
0.5 |
| Sex: |
Male |
| Location: |
New York |
| Vaccinated: | 1990-07-17 |
| Onset: | 1990-07-17 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-07-30 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
262913 / 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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC Split Type:
Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation. |
