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VAERS ID: | 259002 |
VAERS Form: | |
Age: | 56.0 |
Gender: | Female |
Location: | Illinois |
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPH. (J-VAX) / AVENTIS PASTEUR, INC. | EJN222A / 1 | RA / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPH. (J-VAX) JAPANESE ENCEPHALITIS (JE-VAX) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR | EJN222A / 1 | RA / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited China. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / AVENTIS PASTEUR SANOFI PASTEUR | EJN222A / 1 | RA / - |
Administered by: Unknown Military Purchased by: Unknown Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited China. foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR | EJN222A / 1 | RA / - |
Administered by: Military Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR | EJN222A / 1 | RA / - |
Administered by: Military Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR | EJN222A / 1 2 | RA / - |
Administered by: Military Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR | EJN222A / 2 | RA / - |
Administered by: Military Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR | EJN222A / 2 | RA / - |
Administered by: Military Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR | EJN222A / 2 | RA / - |
Administered by: Military Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR | EJN222A / 2 | RA / - |
Administered by: Military Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
Vaccinated: | 2006-06-12 |
Onset: | 2006-06-17 |
Submitted: | 2006-06-29 |
Entered: | 2006-06-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR | EJN222A / 2 | RA / - |
Administered by: Military Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2
Write-up: Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.
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