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This is VAERS ID 28820

Case Details

VAERS ID: 28820 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Female  
Location: Oregon  
Vaccinated:1991-01-30
Onset:1991-01-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 291931 / 5 RL / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Anorexia, Fibrosis tendinous, Myositis, Oedema, Osteoarthritis, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (narrow), Tendinopathies and ligament disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: NO INFO~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Culture - negative
CDC Split Type:

Write-up: Local rxn w/massive swelling - Hospitalized & operated to relieve pressure -myositis or fascititis. Fever of 102; decreased po intake. Thigh tense w/increased warmth, tender to palpation, knee effusion;Probable cellulitis w/sympathetic KE.


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