National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 273714

(NOTE: This result is from the 4/7/2010 version of the VAERS database)

Case Details

VAERS ID: 273714 (history)  
Form: Version .0  
Age: 0.5  
Gender: Male  
Location: Michigan  
Vaccinated:2007-01-15
Onset:2007-01-25
   Days after vaccination:10
Submitted: 2007-03-02
   Days after onset:36
Entered: 2007-03-09
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B084CA / 2 LL / -
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR UF058AA / 2 LL / -
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES B08670B / 2 LL / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1110F / 2 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Abdominal X-ray, Barium enema, Haematochezia, Ileus paralytic, Intussusception, Lethargy, Small intestinal obstruction, Urinary system X-ray, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE. Meds: none.
Current Illness: NONE
Preexisting Conditions: NONE. PMH: none. Allergies: NKDA.
Allergies:
Diagnostic Lab Data: Abdominal x-rays and barium enema. Labs and Diagnostics: KUB reveals an abnormal gas pattern which may reflect a mild paralytic ileus or small bowel obstruction. Contrast Barium Enema revealed an intussusception distal to the hepatic fle
CDC Split Type:

Write-up: Intussusception diagnosed. History of vomiting for several days then had bloody stools. 03/20/2007 MR received for a 2 night hospital stay for several day history of vomiting. Over the course of the admission the infant developed bloody stools x2 as well as bilious vomiting. Review of systems on admission (+) for vomiting and lethargy. PE: WNL except mildly difficult to arouse. Intussusception reduced with air enema. The infant was dicharged the following day. Discharge DX: Intussusception.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100407&IDNUMBER=273714


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