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This is VAERS ID 264467

Case Details

VAERS ID: 264467 (history)  
Form: Version 1.0  
Age: 0.34  
Gender: Female  
Location: Kentucky  
Vaccinated:2006-09-01
Onset:2006-09-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1397AB / 2 LL / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE930AA / 2 LL / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR X1166 / 2 RL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08683E / 2 RL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0139F / 2 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Haematochezia, Intestinal ischaemia, Intussusception, Necrosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Initial exam showed bloody stools, intussusception. DC DX: Intussusception. Procedure: exp. lap. with reduction of intussuception and right hemicolectomy. Taken emergently to operating room after water-soluble contrast enema was unable to reduce intussusception. Currant jelly stools starting at 8am on 9/17/06. Mass palpable at the midline of her abdomen. Hospital course uneventful, developed rash thought to be due to Unasyn, changed to Clindamycin. Surgical pathology report: sections show extensive ischemic necrosis secondary to intussusception. Appendiceal nucosa also shows ischemic necrosis. The amount of lymphoid tissue appears to be increased. Resected margins contain viable tissue.


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