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This is VAERS ID 273495

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 273495 (history)  
Form: Version .0  
Age: 0.3  
Gender: Female  
Location: Georgia  
Vaccinated:2007-02-28
Onset:2007-03-01
   Days after vaccination:1
Submitted: 2007-03-06
   Days after onset:5
Entered: 2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC Split Type:

Write-up: Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated saus"age like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending


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