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This is VAERS ID 272462

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 272462 (history)  
Form: Version 1.0  
Age: 0.47  
Gender: Female  
Location: Maryland  
Vaccinated:2007-01-24
Onset:2007-02-17
   Days after vaccination:24
Submitted: 2007-02-17
   Days after onset:0
Entered: 2007-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 2 - / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0940F / 2 - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Air contrast enema x 2
CDC Split Type:

Write-up: Intussussception. 3/20/07 Received medical records from hospital which reveal patient experienced vomiting & bloody stools for 1 day. Seen at outlying ER on 2/16 & tx w/air contrast enema for +IS then transferred for higher level of care. Admitted to hospital 2/17-2/24/07. Air contrast enema from outlying ER successful but f/u US of abdomen revealed IS had recurred. Repeat air contrast enema reduced IS but again recurred & was so was taken to OR. Stayed in PICU for several days observation & treated w/antibiotics & TPN. Transitioned to oral feeds & antibiotics d/c 2 days prior to d/c home w/o further complication. FINAL DX: Intussusception, RLQ in cecum, adjacent to eleocecal valve. Surgically reduced after failure of air contrast enemas x 2. Exp lap; segmental resection of IS, ileal; & enteroenterostomy.


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