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This is VAERS ID 277352

Case Details

VAERS ID: 277352 (history)  
Form: Version 1.0  
Age: 50.0  
Gender: Female  
Location: Michigan  
   Days after vaccination:0
Submitted: 2007-04-24
   Days after onset:61
Entered: 2007-04-25
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Condition aggravated, Facial palsy, Guillain-Barre syndrome, Nuclear magnetic resonance imaging normal
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? Yes
Previous Vaccinations:
Current Illness: Hearing loss; Facial nerve disorder; Lyme disease; Pruritus; Arthritis; Allergic reaction to antibiotics; Drug hypersensitivity
Preexisting Conditions: PMH: +Lyme dx, treated. Hearing decreased. RA. Pancreatitis. MVP. Carotid enlargement. Goiter
Diagnostic Lab Data: Unknown LABS: CT & MRI of head were WNL. WBC 6.9Lyme serology was +. HSV-1 IgG elevated at 4.20 CSF c/s neg, glucose elevated at 84, protein normal at 23.
CDC Split Type: WAES0704USA03897

Write-up: Information has been received from a registered nurse, concerning a 50 year old female with hearing loss (16-AUG-2007), a facial nerve disorder, Lyme disease with arthritis, pruritus, multiple allergic reactions to antibiotics including tetracycline, CECLOR and KEFLEX, and multiple drug hypersensitivities including morphine, and propoxyphene and DARVOCET, who on 21-FEB-2007 was vaccinated with the first dose, 0.5 ml, IM in the left deltoid, of GARDASIL (lot #656372/0243U). Concomitant therapy included INDERAL, MINOCIN, TRILISATE TABLETS/LIQUID), DIAMOX and MIDRIN. On 05-APR-2007 the patient was hospitalized after she developed facial palsy. The nurse reported that on 09-APR-2007, the patient called the office to report her condition. The patient remained hospitalized until 16-APR-2007, and on that day she called the office, and stated that she "had a possible diagnosis of Guillian Barre syndrome." The patient reported she believed that Gardasil caused her condition, and had requested a human papilloma virus antibody test. The reporter considered the event of facial palsy and possible Guillian Barre syndrome to be an other significant medical event. Additional information has been requested. 5/27/08 Received additional medical records from FDA which patient had provided & include consultant records from out of state clinic neurologist on 10/02/2007 diagnosing w/GBS Miller Fisher variant. Tx w/IVIG w /some improvement but residual facial deficits. Patient also submitted own VAERS report. 5/29/07 Received hospital medical records which reveal patient experienced sudden inability to speak, close eyelids or move face, and unable to swallow. Admitted 4/4-4/16/07. Neuro & Psych consults done. Treated w/IV antibiotics in hospital & continued on IV antibiotics at home FINAL DX: cerebral Lyme disease. 1/21/2010 Many permanent, significant, severe and disabling neurological and other-including whole body-symptoms from Guillian Barre Syndrome.

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