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This is VAERS ID 279290

Case Details

VAERS ID: 279290 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Male  
Location: Texas  
Vaccinated:2007-04-09
Onset:2007-05-08
   Days after vaccination:29
Submitted: 2007-05-22
   Days after onset:14
Entered: 2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 3 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258H / 3 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 3 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Decreased appetite, Diarrhoea, Faeces discoloured, Fluid replacement, Full blood count, Intussusception, Metabolic function test, Occult blood positive, Rotavirus test negative, Surgery, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage laboratory terms (narrow), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: convalescent of Ear infection and upper respiratory infection
Preexisting Conditions: allergic to amoxil medication
Allergies:
Diagnostic Lab Data: While hospitalized he had a CBC,CMP,Urinalysis,single colon barium enema exam,and the rotavirus exam.Stools were positive for guaiac,rotavirus exam was negative,electrolytes corrected and CBC was within normal range.the impression on the colon barium exam was that there was intussusception colocolic at the level of the hepatic flexure of the colon.The patient underwent surgery and incidental appendectomy. records received 6/5/07-Labs: WBC 19.9. Blood and urine cultures no growth. Barium enema:Intussusception most likely colocolic at the level of hepatic flexure of colon.
CDC Split Type:

Write-up: Patient vomited 6 times on date of service 05/09/07 and poor appetite.The day before, he vomited 3 times.We administered Phenegran 0.3ml for the vomiting.He was given pedialyte and gatorade at home.He was admitted to the hospital.He was placed on IV fluids.He had one loose stool with a little red color, the day after admission,child was distended.X-Ray suggested Intussusception and barium enema comfirmed it. surgery was done shortly after 06/05/07-records received from facility for DOS 5/9-5/11/07. DX:Intussusception. Dehydration, Left Otitis Media, Upper Respiratory Infection, Vomiting. Surgery:explaratory laporotomy with reduction of intussusception and incidental appendectomy. 48 hours prior to admission had progressive abdominal distention, vomiting and two episode of bloody stools. . Initially admitted for feeding difficulites and fever since previous night. During course of hospitalization developed diarrhea and vomiting and abdominal distention.


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