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This is VAERS ID 275807

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275807
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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: Carbon dioxide decreased, Culture stool positive, Feeling cold, Bacteria stool identified, Clostridial infection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) 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.


Changed on 12/8/2009

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 3/2/2010

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B08670C / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 4/7/2010

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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 (PREVNAR7) 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: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 8/31/2010

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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 PFIZER/WYETH B08670C / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 4/13/2011

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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) / PFIZER/WYETH B08670C / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 5/13/2011

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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) / PFIZER/WYETH B08670C / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 6/11/2011

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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) / PFIZER/WYETH B08670C / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 5/13/2013

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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) / PFIZER/WYETH B08670C / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 5/14/2017

275807 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
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) / PFIZER/WYETH B08670C / 0 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Carbon dioxide decreased, Culture stool positive, Feeling cold, Gastrointestinal haemorrhage, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Ileostomy, Intensive care, Intestinal infarction, Intestinal ischaemia, Intussusception, Irritability, Jejunostomy, Lethargy, Livedo reticularis, Poor peripheral circulation, Pulse pressure decreased, Red blood cell count decreased, Shock, Small intestinal resection, Surgery, Swelling, Tachycardia, Intestinal resection, Urine output decreased, Bacteria stool identified, Clostridial infection, Rotavirus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


Changed on 9/14/2017

275807 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-03-23
Onset:2007-03-28
Submitted:2007-04-09
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 0 1 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1242F / 0 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y1031-2 / 0 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08670C / 0 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1032F / 0 1 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Carbon dioxide decreased, Culture stool positive, Gastrointestinal haemorrhage, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Intensive care, Intussusception, Lethargy, Livedo reticularis, Red blood cell count decreased, Surgery, Swelling, Intestinal resection, Bacteria stool identified

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None PMH: delivered at term by c-section due to lack of progression. Had been developing normally w/o difficulty.
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. LABS: Hgb initially 12g & dropped to 7g w/n 5 hours. Transfused. Acidotic. Rotavirus neg. Multiple pages of lab results received.
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. 5/15/07 Received medical records from hospital which reveal patient experienced fussiness, bloody stools & massive GI bleed. Initially seen at outlying ER where patient found to be in shock & transferred to higher level of care. Admitted from 3/28-5/3/07. Pulses & perfusion were extremely poor, he was tachycardic, poor urine output & he was cold & mottled. Surgical consult done, central line placed & patient transfused. Taken to OR on 4/3/07 where found ischemia & infarction of small bowel. Resection of jejunum done; leaving only approx 30 cm jejunum. Proximal jejunostomy created w/ileostomy & mucous fistula performed using approx 15 cm of terminal ileum. Started on TPN & very slowly built up to 5 mL/TID at d/c oral feeding. Treated w/multiple antibiotics while hospitalized & developed c. difficile. Continued on TPN at d/c w/Home Health follow up due to high output jejunostomy. FINAL DX: ischemia & infarction of small bowel; resection of small bowel w/creation of jejunostomy.


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