| VAERS ID: |
25648 (history) |
| Form: |
Version 1.0 |
| Age: |
1.5 |
| Sex: |
Female |
| Location: |
Texas |
| Vaccinated: | 1989-11-17 |
| Onset: | 1989-11-17 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-08-06 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
- / UNK |
- / - |
| HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
- / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
- / UNK |
- / - |
Administered by: Private Purchased by: Unknown
Symptoms: Convulsion,
Pallor,
Pyrexia,
Stupor,
Visual disturbance
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC Split Type: 8902745.01
Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure. |
