National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 284183

(NOTE: This result is from the 5/13/2013 version of the VAERS database)

Case Details

VAERS ID: 284183 (history)  
Form: Version .0  
Age: 0.2  
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-15
Onset:2007-05-22
   Days after vaccination:7
Submitted: 2007-07-09
   Days after onset:48
Entered: 2007-07-10
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2628M / 0 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1416F / 0 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0922 / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B0876920 / 0 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0235N / 0 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative, Culture urine negative, Faeces discoloured, Fluid intake reduced, Intussusception, Lethargy, Mucosal dryness, Occult blood positive, Ultrasound abdomen, Urinary system X-ray, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage laboratory terms (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Biliary system related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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, 2 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown. PMH:none.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: KUB showed distended small and large bowel loops. Barium enema done-intussusception identified and reduced. Repeat US was done post reduction with no evidence of recurrent IS. Labs and Diagnsotics: KUB 5/2
CDC Split Type: WAES0707USA00032

Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130513&IDNUMBER=284183


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166