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This is VAERS ID 268143

Case Details

VAERS ID: 268143 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Alaska  
Vaccinated:2006-11-22
Onset:2006-11-30
   Days after vaccination:8
Submitted: 2006-12-03
   Days after onset:3
Entered: 2006-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Areflexia, Arthropathy, Blood product transfusion, CSF glucose normal, CSF white blood cell count increased, Computerised tomogram abnormal, Cough decreased, Dysstasia, Fall, Gait disturbance, Guillain-Barre syndrome, Headache, Hypokinesia, Increased bronchial secretion, Mechanical ventilation, Motor dysfunction, Muscular weakness, Paraesthesia, Peroneal nerve palsy, Residual urine, Retching, Sinusitis, Staphylococcal infection, Urinary tract infection, Wean from ventilator
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 67 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec prn, guaifenesin prn, tylenol prn
Current Illness: I don''t have this info
Preexisting Conditions: None that I''m aware of
Allergies:
Diagnostic Lab Data: Elevated protein in CSF; clinical symptoms suggestive of Guillain-Barre syndrome (primarily motor weakness, some altered sensation) Head CT normal except for sinusitis. Coag negative staph UTI. CSF: protein 64, glucose 57 and 7WBC. EMG on 12/5 demonstrated severe neuropathy, appeared to be a more severe form of Guillain-Barre with Miller-Fisher variant with a lot of bulbar symptoms.Bronchoscopy demonstrated H.flu left lower lobe pneumonia.
CDC Split Type:

Write-up: Pt admitted to hospital on 12/1/06 with chief complaint of ascending weakness bilaterally, upper and lower extremities. Neuro consult diagnosed Guillain-Barre syndrome. Pt received the Gardasil vaccine on 11/22/06. Resident MD asked pharmacist to write up possible ADR of Guillain-Barre from this vaccine. 02/21/2007 records received and reviewed for DOS:12/1/06-02/06/2007 DC DX:Severe form of Guillain-Barre syndrome after HPV vaccine and possible URI. Respiratory failure with prolonged mechanical ventilation and tracheostomy tube placement. Haemophilus influenzae, left lower lobe pneumonia, coag negative staph UTI. Hypertension. Tachycardia associated with dysautonomia now resolved. Presented to PCP with URI around Thanksgiving with associated sinus infection. Began having numbness and tingling in hands days of admission as well as back pain, headache and greater problems walking and began falling over. Able to wiggle her toes but with great difficulty. Pneumococcal vaccine in September/October. HPV vaccine on 11/22/06. Mother has possible MS and possible lupus. Neuro exam:Weakness of deltoid bilaterally, weakness of lower extremities with grade 4/5 weakness at hip flexor, 4/5 hip extension, 4/5 knee flexion, 4+/5 knee extension and 3+/5 plantar flexion. Deep tendon reflexes absent in all extremities even with augmentation. Plantar responses downgoing. Gait abnormal some degree of pelvic girdle weakness and foot drop bilaterally.Began IVIG. On day 2 began developing post void residuals. Vital capacity deteriorated on day 3 to 2.2 increasing difficulties with secretions as her gag and cough diminished. Able to move only jaw and eyes. Intubated and placed on fentanyl and versed. Developed HTN. Developed neuropathic pain. At discharge able to stand with assistance. Off vent on 1/26/07. Tachycardia and hypertension associated with autonomic dysfunction now resolved at discharge. Did not completely recover as of Feb 2007 when she was discharged from a rehabilitation institute. Still needing physical & speech therapy. Diagnosis, Guillain-Barre syndrome Per annual follow up information: Unfortunately, since this was a courtesy injection and pt is not our pt we have not seen this pt since and I can not say for sure if she is fully recovered-Sorry. Per 60 day follow up: Unfortunately-pat is seen by another provider & we only did the shot as a courtesy so we have not seen the pt since- Have heard through the grapevine that pt is in Rehab now & off the ventilator & standing to walk again. Per 60 day follow up: Did not completely recover as of Feb 2007 when she was discharged from a rehabilitation institute. Still needing physical & speech therapy. Diagnosis: GUILLAIN-BARRE syndrome


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