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This is VAERS ID 283993

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 283993 (history)  
Form: Version .0  
Age: 0.5  
Gender: Female  
Location: Wisconsin  
Vaccinated:2007-06-06
Onset:2007-06-30
   Days after vaccination:24
Submitted: 2007-07-02
   Days after onset:2
Entered: 2007-07-06
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B101AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08674A / 2 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0236U / 2 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Abdomen scan, Abdominal X-ray, Barium enema, Blood electrolytes normal, Computerised tomogram
SMQs:

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: PMH: none noted. NKDA.
Allergies:
Diagnostic Lab Data: Abdominal X-ray, U/S, CT, barium enema, CBC, UA, Chem labs. Labs and Diagnostics: CBC normal, electrolytes normal, CXR and KUB normal. Abd ultrasound with abnormal segment of bowel in the RUQ with thickening (bowel in bowel?) Suggests uppe
CDC Split Type:

Write-up: Intussusception 6/30 Surgical correction 7/1. Infant presented to ER with multiple episodes of vomiting, no diarrhea. Child transfered to admitting hospital. 07/30/2007 MR received from admitting hospital for DOS 7/1-4/2007. She was transferred via helic"opter for eval and tx for an irreducible Intussusception. Child had an exploratory lap with reduction of ileocolic intussusception. Intussuscepted bowel was 2'''' to a Meckel diverticulum. Resection of Meckel Diverticulum and ileum also done. Discharge


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