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This is VAERS ID 279082

Case Details

VAERS ID: 279082 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-03-28
Onset:2007-04-30
   Days after vaccination:33
Submitted: 2007-05-21
   Days after onset:21
Entered: 2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB148AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 01884 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2141AA / 1 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Nerve conduction studies, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)

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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Recurring chest pain. Evaluated by dermatology for multiple nevi.
Preexisting Conditions: Persistent left sided chest pain of unclear origin since Jan 19, 2007. Has speckled positive ANA 1:160 since Jan 22, 2007. Cleared by cardiology and was to be seen by rheumatology.
Allergies:
Diagnostic Lab Data: CT Scan, MRI of head and Spine, Nerve Conduction Studies, multilpel lab studies records received 6/5/07-CXR normal. CT of brain and MRI of brain normal. MRI c-spine, t-spine and l-spine normal. EEG normal. CSF cultures negative. Hep A,B, and C negative. HSV negative. ANA equivocal but double stranded DNA negative. Lyme PCR negative. Enterovirus PCR, varicella zoster PCR negative. IgG, IgM, CMV and mycoplasmal pneumonia pending.
CDC Split Type:

Write-up: Patient presented 5/10/07 with a ten history of tingling in the right hand. On 5/14/07, she presented with right foot pain and numbness as well. She was referred to the Neurologist where she had an appointment 5/15/07. Patient was admitted, after ER evaluation, on 5/16/07. Patient was treated with IVIG in the hospital and multiple tests were ordered. Patient''s working diagnosis is Landry-Guillain-Barre Miller-Fisher variant. 06/05/07-records received from facility for DOS 05/16-05/21/07-DC DX: Guillain Barre variant. Left Bell''s Palsy. Paresthesias. C/O numbness in dorsum of right hand progressing up her forearm also left foot numbness progressing up her leg and a left facial droop. Numbness started in right hand approximately 1 month after received HPV, Hep A and Menactra vaccine. HX of living in woods and a family pet with ticks. PE: Crainal nerves II through XII intact with exception of mild left facial droop. Paresthesias of bilateral lower extremity and hands and arms in glove and stocking formation. Strength and motor intact. Treated with IVIG. Symptoms without progression and slight improvement daily. Lost reflex in lower extremities but at time of discharge 2+ of right but have not returned on left


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