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This is VAERS ID 278503

Case Details

VAERS ID: 278503 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Connecticut  
Vaccinated:2007-04-12
Onset:2007-04-23
   Days after vaccination:11
Submitted: 2007-05-09
   Days after onset:16
Entered: 2007-05-14
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2172AA / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Electromyogram, Full blood count, Guillain-Barre syndrome, Lumbar puncture, Mycoplasma serology positive
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Infective pneumonia (broad)

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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LP< EMG - CBC, General , + mycoplasma titers records received 6/20/07-Mycoplasma positive. EBV negative. CSF showed high protein and normal cells. NIF scores 30.
CDC Split Type:

Write-up: Guillain Barre 6/20/07-records received from facility for DOS 4/29-5/5/07- DC DX: Guillain-Barre Syndrome. Presented with paresthesia for 1 weeks. First noticed having a left eye twitch and numbness to left face preceded by tingling and paresthesias of fingers and toes. Treated with IVIg. Only mild residuals at discharge. PE:neuro fair strength in upper extremities and lower extremities, absent reflexes mainly in lower extremities. No sensory deficit, downgoing plantars, no muscle wasting. Gait peroneal.


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