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This is VAERS ID 279290

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279290
VAERS Form:
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B36258H / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Blood culture negative, Body temperature increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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 co
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 fluid"s.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


Changed on 12/8/2009

VAERS ID: 279290 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 RL / IM
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B36258H / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Blood culture negative, Body temperature increased, Culture urine negative, Diarrhoea, Faeces discoloured, Full blood count, Haematochezia, Intussusception, Laparotomy, Surgery, Urine analysis, Vomiting, White blood cell count increased, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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 co
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 fluid"s.He 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.


Changed on 3/2/2010

VAERS ID: 279290 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B36258H / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Blood culture negative, Body temperature increased, Culture urine negative, Diarrhoea, Faeces discoloured, Full blood count, Haematochezia, Intussusception, Laparotomy, Surgery, Urine analysis, Vomiting, White blood cell count increased, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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 co
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.


Changed on 4/7/2010

VAERS ID: 279290 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 LL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B36258H / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Blood culture negative, Body temperature increased, Culture urine negative, Diarrhoea, Faeces discoloured, Full blood count, Haematochezia, Intussusception, Laparotomy, Surgery, Urine analysis, Vomiting, White blood cell count increased, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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 co
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.


Changed on 8/31/2010

VAERS ID: 279290 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH B36258H / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Blood culture negative, Body temperature increased, Culture urine negative, Diarrhoea, Faeces discoloured, Full blood count, Haematochezia, Intussusception, Laparotomy, Surgery, Urine analysis, Vomiting, White blood cell count increased, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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 co
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.


Changed on 5/13/2013

VAERS ID: 279290 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258H / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Blood culture negative, Body temperature increased, Culture urine negative, Diarrhoea, Faeces discoloured, Full blood count, Haematochezia, Intussusception, Laparotomy, Surgery, Urine analysis, Vomiting, White blood cell count increased, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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 co
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.


Changed on 2/14/2017

VAERS ID: 279290 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258H / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Blood culture negative, Body temperature increased, Culture urine negative, Diarrhoea, Faeces discoloured, Full blood count, Haematochezia, Intussusception, Laparotomy, Surgery, Urine analysis, Vomiting, White blood cell count increased, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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 co 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.


Changed on 9/14/2017

VAERS ID: 279290 Before After
VAERS Form:(blank) 1
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 3 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258H / 2 3 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 2 3 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium enema, Diarrhoea, Faeces discoloured, Full blood count, Intussusception, Surgery, Urine analysis, Vomiting, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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.


Changed on 2/14/2018

VAERS ID: 279290 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
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, Diarrhoea, Faeces discoloured, Full blood count, Intussusception, Surgery, Urine analysis, Vomiting, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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.


Changed on 6/14/2018

VAERS ID: 279290 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Texas
Vaccinated:2007-04-09
Onset:2007-05-08
Submitted:2007-05-22
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, Diarrhoea, Faeces discoloured, Full blood count, Intussusception, Surgery, Urine analysis, Vomiting, Decreased appetite, Fluid replacement, Occult blood positive, Metabolic function test, Rotavirus test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     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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