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This is VAERS ID 274158

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 274158 (history)  
Form: Version .0  
Age: 0.2  
Gender: Female  
Location: California  
Vaccinated:2007-02-28
Onset:2007-03-08
   Days after vaccination:8
Submitted: 2007-03-16
   Days after onset:7
Entered: 2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 06E605 / 1 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal X-ray, Abdominal mass, Barium enema, Blood culture negative, Culture urine negative, Decreased appetite, Differential white blood cell count abnormal, Intussusception, Lethargy, Platelet count increased, Urinary casts, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: NONE
Current Illness: TAKING SYNAGIS FOR RSV PROPHYLAXIS
Preexisting Conditions: 34 WEEK PREEMIE PMH: preemie at 34.5 wks, born by c-section.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed IS. Barium enema reduced IS. WBC 9.2, plt 582, lymphs 40, monos 55, bands 4 & polys 49. UA revealed 3 hyaline casts. Urine & blood c/s were neg.
CDC Split Type:

Write-up: PENELOPE WAS ADMITTED WITH INTUSSUSCEPTION NINE DAYS LATER, AND REDUCED SUCCESSFULLY, AT CHILDREN''S HOSPITAL AT SAN DEIGO 4/3/07 Received medical records from hospital which reveal patient experienced emesis for 3 daysw/decreased feeding beginning 3/5/07 & patient became increasingly lethargic. On exam, palpable mass was felt in abdomen. Kept over night for observation, did well & was d/c to home on 3/9/07. No D/c summary available. FINAL DX: ileocolic intussusception, reduced by barium enema.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=274158


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