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This is VAERS ID 279922

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279922
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08691E / 0 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Barium enema, Crying, Enteritis, Fluid intake reduced, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant wi
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis


Changed on 12/8/2009

VAERS ID: 279922 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 UN / IM
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08691E / 0 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Barium enema, Crying, Enteritis, Haematochezia, Intussusception, Vomiting, Ultrasound abdomen abnormal, Fluid intake reduced, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant wi
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 3/2/2010

VAERS ID: 279922 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 0 UN / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B08691E / 0 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Barium enema, Crying, Enteritis, Haematochezia, Intussusception, Vomiting, Ultrasound abdomen abnormal, Fluid intake reduced, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant wi
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 4/7/2010

VAERS ID: 279922 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 0 UN / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08691E / 0 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Barium enema, Crying, Enteritis, Haematochezia, Intussusception, Vomiting, Ultrasound abdomen abnormal, Fluid intake reduced, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant wi
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 8/31/2010

VAERS ID: 279922 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH B08691E / 0 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Barium enema, Crying, Enteritis, Haematochezia, Intussusception, Vomiting, Ultrasound abdomen abnormal, Fluid intake reduced, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant wi
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 5/13/2013

VAERS ID: 279922 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08691E / 0 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Barium enema, Crying, Enteritis, Haematochezia, Intussusception, Vomiting, Ultrasound abdomen abnormal, Fluid intake reduced, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant wi
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 5/14/2017

VAERS ID: 279922 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08691E / 0 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Barium enema, Crying, Enteritis, Haematochezia, Intussusception, Vomiting, Ultrasound abdomen abnormal, Fluid intake reduced, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant wi with intussusception showing a mass in the right mid and upper abdomen c/w ileocolic intussusception. Therapeutic enema with gastrografin was showed a "probably sucessful reduction of ileocolic IS. Repeat showed no evidence of IS however no reflux into terminal ileum was obtained. ABD X-ray 5/23/2007 WNL.
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 9/14/2017

VAERS ID: 279922 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 0 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 0 1 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08691E / 0 1 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 0 1 - MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant with intussusception showing a mass in the right mid and upper abdomen c/w ileocolic intussusception. Therapeutic enema with gastrografin was showed a "probably sucessful reduction of ileocolic IS. Repeat showed no evidence of IS however no reflux into terminal ileum was obtained. ABD X-ray 5/23/2007 WNL.
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 2/14/2018

VAERS ID: 279922 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 1 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08691E / 1 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 1 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant with intussusception showing a mass in the right mid and upper abdomen c/w ileocolic intussusception. Therapeutic enema with gastrografin was showed a "probably sucessful reduction of ileocolic IS. Repeat showed no evidence of IS however no reflux into terminal ileum was obtained. ABD X-ray 5/23/2007 WNL.
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 6/14/2018

VAERS ID: 279922 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 1 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08691E / 1 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 1 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant with intussusception showing a mass in the right mid and upper abdomen c/w ileocolic intussusception. Therapeutic enema with gastrografin was showed a "probably sucessful reduction of ileocolic IS. Repeat showed no evidence of IS however no reflux into terminal ileum was obtained. ABD X-ray 5/23/2007 WNL.
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 8/14/2018

VAERS ID: 279922 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 1 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08691E / 1 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 1 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant with intussusception showing a mass in the right mid and upper abdomen c/w ileocolic intussusception. Therapeutic enema with gastrografin was showed a "probably sucessful reduction of ileocolic IS. Repeat showed no evidence of IS however no reflux into terminal ileum was obtained. ABD X-ray 5/23/2007 WNL.
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.


Changed on 9/14/2018

VAERS ID: 279922 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:California
Vaccinated:2007-02-27
Onset:2007-04-16
Submitted:2007-05-29
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 1 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08691E / 1 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 1 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: RSV. reflux. NKDA.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: ABD X-ray showed non-specific gas pattern with some air fluid levels and several mildly dilated loops of bowel. Intussusception or partial bowel obstruction are not excluded. ABD US showed an appearance consistant with intussusception showing a mass in the right mid and upper abdomen c/w ileocolic intussusception. Therapeutic enema with gastrografin was showed a "probably sucessful reduction of ileocolic IS. Repeat showed no evidence of IS however no reflux into terminal ileum was obtained. ABD X-ray 5/23/2007 WNL.
CDC 'Split Type':

Write-up: intussusception on 4-16-07 seen at hospital. admitted for emesis. 06/04/2007 MR received for o/n hospital stay for c/o decreased po, crying, vomiting and blood in diaper. Reduced with Barium enema. DX Intussusception. Repeat ER visit 5/23/07 with c/o diarrhea and decreased appetite. DX: Enteritis.

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