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This is VAERS ID 273426

Case Details

VAERS ID: 273426 (history)  
Form: Version 1.0  
Age: 10.0  
Sex: Female  
Location: Pennsylvania  
   Days after vaccination:20
Submitted: 2007-03-05
   Days after onset:1
Entered: 2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arrhythmia, Atrial septal defect, Cardiac arrest, Cough, Nasopharyngitis, Oxygen supplementation, Respiratory arrest, Somnolence, Urinary tract infection, Ventricular hypertrophy, Viral myocarditis, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Congenital, familial and genetic disorders (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 19 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Echocardiogram:dilated right ventricle. severely decreased biventricular systolic function. mild tricuspid/mitral insufficiency. atrial septum bulges. small pleural effusion right.
CDC Split Type:

Write-up: Vaccine administration date 2/12/2007, varicella dose #2 and Gardisil dose #1 administered concurrently. No symptoms until March 4th when in AM noted by mother to have a cold/URI symptoms with cough. Emesis at 11 after soup at 10, napping when mom at home at 3 PM but difficult to arouse. Called 911 and started rescue breathing. Paramedics initially called in stable VS''s but required active CPR on gurney by time came into ED. In disorganized vfib in ER-resusc''d with PALS then consulted cardiology for ECMO. Cannulated for VA ECMO - on full flow support after 1.5 hours. Heart completely akinetic. Went to cath lab to get biopsies, CAD''s and assessment of integrity of heart with very poor tone/strength to heart muscle noted; presumed acute viral myocarditis. Has gotten IVIG. Can''t assess neurologic function due to significant drug load. Remains with very disorganized rhythym today; to consider EPS study; also studying family for possible inherited rhythym disturbances. 03/20/07-partial records received from facility, patient remains in hospital. Received ECMO support for cardiac arrest secondary to myocarditis. Endomyocardial biopsy: acute lymphocytic myocarditis with scattered eosinophils. 04/25/07-DC Summary received for DOS 03/04-03/23/07-DC DX: Cardiac arrhythmia. Myocarditis. Per information received from annual follow up, off all CHF medications; very minimal residual orgainc brain syndrome; responding to PT/OT & counseling.

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