National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 275807

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

Case Details

VAERS ID: 275807 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: California  
Vaccinated:2007-03-23
Onset:2007-03-28
   Days after vaccination:5
Submitted: 2007-04-09
   Days after onset:12
Entered: 2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 0 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1242F / 0 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y1031-2 / 0 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08670C / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Bacteria stool identified, Carbon dioxide decreased, Clostridial infection, Culture stool positive, Feeling cold
SMQs:, Pseudomembranous colitis (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: HR 180-200 on arrival. C. diff positive in stool. RBC 2.47, HBG/HCT 7.6/21.5. CO2 18.
CDC Split Type:

Write-up: Pt presented with GI bleed 3 days post vacinnation and became lethergic, mottled, with severe swelling. Pt was taken to the ED on 03/28. He was later found with acute intussusception and bowel was resected. Currently in PICU.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=275807


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