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This is VAERS ID 286564

Case Details

VAERS ID: 286564 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Texas  
Vaccinated:2007-07-05
Onset:2007-07-13
   Days after vaccination:8
Submitted: 2007-08-02
   Days after onset:20
Entered: 2007-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 2 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0802U / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0535U / 2 RA / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood glucose increased, Diabetes mellitus insulin-dependent
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: glucose - 977 records received 8/30/07-WBC 10.5. Segs 85. Postassium 5.6. carbon dioxide 18.9. Anion Gap of 33, Phosporus 6.6. osmolality of 322. Blood sugar greater than 900.
CDC Split Type:

Write-up: Came to office 1 week after immunizations were given with New onset Type 1 DM with sugar of 977. 8/30/07-records received-for DOS 7/13-7/15/07- DC DX: Diabetic ketoacidosis resolved. Type I diabetes new onset. Dehydration resolved. Hyperkalemia, resolved. Two week history of polyuria, polydipsia, nocturia, dry mouth and blurry vision, 12 pound weight loss for the last month or so. in ED blood sugar over 1000. C/O not feeling well, weak, decreased appetite, nausea and vomiting. 1/11/2010 Patient has type I DM.


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