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Life Threatening? No
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 epysode 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 admitted to hospital, 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. 11/01/2006: MR received from PCP revealing well baby exam of October 25, 2006 where infant received Pediarix, pneumococcal vaccine, and Rotateq./pc 11/3/2006: MR received from overnight hospital stay documenting fever for several days post vax which resolved, and infant was doing well. Five days post vax infant became irritable and lethargic, with poor appetite, and was noted to have had one episode of bloody stool the day prior, and continued to have mucus in his stool. Infant was admitted to the hospital at this time to R/O intussusception. Gastrographin enema was performed which reduced the intussusception, and was confirmed by Abdominal X-ray the next day. Infant was discharged. No d/C summary dictated./pc Report received from pediatrician revealing F/U exam for intussusception on 11/2/2006: no fever, no vomiting, increased appetite. Stool to be sent to CDC for analysis/pc
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