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This is VAERS ID 274158

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

Case Details

VAERS ID: 274158 (history)  
Form: Version 1.0  
Age: 0.18  
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
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 06E605 / 2 MO / PO

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, 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: PATIENT WAS ADMITTED WITH INTUSSUSCEPTION NINE DAYS LATER, AND REDUCED SUCCESSFULLY, AT HOSPITAL 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=20170914&IDNUMBER=274158


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