National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 272372

(NOTE: This result is from the 4/13/2011 version of the VAERS database)

Case Details

VAERS ID: 272372 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: Texas  
Vaccinated:2006-12-06
Onset:2007-01-17
   Days after vaccination:42
Submitted: 2007-02-15
   Days after onset:29
Entered: 2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21BO74BA / 0 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF023AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH BO8682D / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1113F / 0 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium enema, Blood alkaline phosphatase increased, Blood creatinine decreased, Blood urea nitrogen/creatinine ratio increased, Diarrhoea haemorrhagic, Intussusception, Irritability, Laboratory test, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract
SMQs:, Acute renal failure (broad), Liver related investigations, signs and symptoms (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Biliary system related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Labs and UGI on hospitalization LABS: Barium enema attempted to reduce intussusception but was unsuccessful. WBC 15.3, alk phos 293, creatinine 0.2, BUN 14. ratio 70.
CDC Split Type:

Write-up: Vomiting on 01-17-07 with subsequent hospitatlization for intussuception requiring surgical intervention. 3/15/07 Received medical records from hospital which reveal patient experienced acute onset irritability, vomiting & bloody diarrhea for 24 hrs prior to admit on 01/17/07. Be enema unsuccessful & patient taken to OR for surgical reduction & appendectomy. Progressed well & was d/c to home on 01/18/07. Final Dx: Intussusception, surgically reduced; appendectomy.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20110413&IDNUMBER=272372


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166