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This is VAERS ID 265698

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 265698 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: Texas  
Vaccinated:2006-10-25
Onset:2006-10-29
   Days after vaccination:4
Submitted: 2006-10-31
   Days after onset:2
Entered: 2006-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP HEPB IPV (PEDIARIX) / GLAXOSMITHKLINE AC21BO73AA / 0 RL / IM
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR, INC. OE84AA / 0 LL / IM
PNC: PNEUMO, 7-VALENT (PREVNAR) / LEDERLE LABORATORIES BO862D / 0 LL / IM
ROTHB5: ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT (ROTATEQ) / MERCK & CO. INC. 0319F / 0 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Decreased appetite, Dehydration, Diarrhoea haemorrhagic, Intestinal obstruction
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: I ordered an abdominal CT which was suggestive of intussusception, this was confirmed with gastrographin enema which also reduced it. Pt did well after intervention, recovered and was discharged the following day
CDC Split Type:

Write-up: Pt. is a 2 mo infant that recived his immunizations on 10/25/06 (pediarix, HiB, PCV and Rotateq). He had 2 days with reported fever, improved by day 3, on day 5 his parents noticed irritability, decreased appetite and also reported 2 emesis and one epyso"de of diarrhea with blood and mucus. They presented to our office where I found a sick looking infant, lethargic and mildly dehydrated. On physical exam he had abdominal pain. Abdominal films revealed several air-fluid levels and distention. Pt was ad


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