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This is VAERS ID 276540

Case Details

VAERS ID: 276540 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Female  
Location: Colorado  
   Days after vaccination:11
Submitted: 2007-04-06
   Days after onset:10
Entered: 2007-04-17
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Abasia, Blood culture negative, C-reactive protein increased, Chest X-ray normal, Culture urine negative, Flushing, Hypokinesia, Hypotension, Myalgia, Pyrexia, Rash, Red blood cell sedimentation rate increased, Streptococcus identification test, Streptococcus identification test negative, X-ray of pelvis and hip normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prevacid
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: BCx x 2 Neg, Ck <7, Strep (-), ASO (-), CXR (-), Pelvic (-), UCx x 2 neg, CRP = 8.3, ESR = 36 Records received 4/19/07-CXR normal. EKG WNL. Elevated WBC. CK WNL. Blood and urine cultures negative.
CDC Split Type:

Write-up: Severe myalgias starting 3/27/07 to the point of being unable to sit up or walk. Fever stated 4/4/07 PM. With in 1 hr of onset of fever, pt became hypotensive and had a flushing rash. She was admitted to the PICU and supported with pressors. As of 4/6/07, she is improving. No source had been identified. CK <7, BCXs neg. 04/19/07-records received from facility-DOS 4/4-4/10/07-DC DX: Hypotension. Rash. Presented with 2 week history not feeling well with significant myalgias. C/O sore throat, throat culture negative. Nausea, diarrhea. Developed progressive muscle pain. RX with dopamine. Source of infection may have been area of inflammation on back of earlobe at earring hole site.

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