National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 295507

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 295507
VAERS Form:
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2139AA / 0 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Ataxia, Azotaemia, Barium swallow normal, Blood creatinine increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR
CDC 'Split Type':

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solum"edrol and Prednisone taper started with improvement in all sx''''s except diplopia.


Changed on 12/8/2009

VAERS ID: 295507 Before After
VAERS Form:
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2139AA / 0 UN / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Asthenia, Ataxia, Azotaemia, Barium swallow normal, Blood creatinine increased, Blood glucose increased, Blood urea increased, Clonus, CSF culture negative, CSF oligoclonal band present, Culture urine positive, Diplopia, Encephalopathy, Fall, Full blood count, Gait disturbance, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Pain, Red blood cells CSF positive, Strabismus, Ultrasound kidney normal, Leukoencephalomyelitis, IIIrd nerve paresis, Fungus CSF test negative, CSF myelin basic protein increased, Eye movement disorder, Toxicologic test normal, Scan brain, CSF virus no organisms observed, Urine analysis abnormal, Renal impairment

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow
CDC 'Split Type': (blank) TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solum"edrol Solumedrol and Prednisone taper started with improvement in all sx''''s sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.


Changed on 4/7/2010

VAERS ID: 295507 Before After
VAERS Form:
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 0 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Asthenia, Ataxia, Azotaemia, Barium swallow normal, Blood creatinine increased, Blood glucose increased, Blood urea increased, Clonus, CSF culture negative, CSF oligoclonal band present, Culture urine positive, Diplopia, Encephalopathy, Fall, Full blood count, Gait disturbance, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Pain, Red blood cells CSF positive, Strabismus, Ultrasound kidney normal, Leukoencephalomyelitis, IIIrd nerve paresis, Fungus CSF test negative, CSF myelin basic protein increased, Eye movement disorder, Toxicologic test normal, Scan brain, CSF virus no organisms observed, Urine analysis abnormal, Renal impairment

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow
CDC 'Split Type': TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solumedrol and Prednisone taper started with improvement in all sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.


Changed on 4/14/2017

VAERS ID: 295507 Before After
VAERS Form:
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 0 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Asthenia, Ataxia, Azotaemia, Barium swallow normal, Blood creatinine increased, Blood glucose increased, Blood urea increased, Clonus, CSF culture negative, CSF oligoclonal band present, Culture urine positive, Diplopia, Encephalopathy, Fall, Full blood count, Gait disturbance, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Pain, Red blood cells CSF positive, Strabismus, Ultrasound kidney normal, Leukoencephalomyelitis, IIIrd nerve paresis, Fungus CSF test negative, CSF myelin basic protein increased, Eye movement disorder, Toxicologic test normal, Scan brain, CSF virus no organisms observed, Urine analysis abnormal, Renal impairment

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow with no penetration or aspiration. Admission CBC unremarkable. CMP with normal BUN and Creatinine with elevations beginning 8/16/07: BUN 20-57, Creatinine 1.8-3.8. Serum glucose elevations began 8/17/07. CSF with (+) RBCs with (+) oligoclonal bands. CSF MBP 7.76. CSF culture (-). No fungi in CSF. CSF HSV (-).Phytanic and Pristanic Acids WNL. Urine creatinine 52. UA with 1+ bacteria. UC (+) for Gram - bacillus and staph species. Tox screen (-).
CDC 'Split Type': TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solumedrol and Prednisone taper started with improvement in all sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.


Changed on 9/14/2017

VAERS ID: 295507 Before After
VAERS Form:(blank) 1
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 0 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Ataxia, Azotaemia, Blood creatinine increased, Blood urea increased, Diplopia, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Leukoencephalomyelitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow with no penetration or aspiration. Admission CBC unremarkable. CMP with normal BUN and Creatinine with elevations beginning 8/16/07: BUN 20-57, Creatinine 1.8-3.8. Serum glucose elevations began 8/17/07. CSF with (+) RBCs with (+) oligoclonal bands. CSF MBP 7.76. CSF culture (-). No fungi in CSF. CSF HSV (-).Phytanic and Pristanic Acids WNL. Urine creatinine 52. UA with 1+ bacteria. UC (+) for Gram - bacillus and staph species. Tox screen (-).
CDC 'Split Type': TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solumedrol and Prednisone taper started with improvement in all sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.


Changed on 2/14/2018

VAERS ID: 295507 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Ataxia, Azotaemia, Blood creatinine increased, Blood urea increased, Diplopia, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Leukoencephalomyelitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow with no penetration or aspiration. Admission CBC unremarkable. CMP with normal BUN and Creatinine with elevations beginning 8/16/07: BUN 20-57, Creatinine 1.8-3.8. Serum glucose elevations began 8/17/07. CSF with (+) RBCs with (+) oligoclonal bands. CSF MBP 7.76. CSF culture (-). No fungi in CSF. CSF HSV (-).Phytanic and Pristanic Acids WNL. Urine creatinine 52. UA with 1+ bacteria. UC (+) for Gram - bacillus and staph species. Tox screen (-).
CDC 'Split Type': TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solumedrol and Prednisone taper started with improvement in all sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.


Changed on 6/14/2018

VAERS ID: 295507 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Ataxia, Azotaemia, Blood creatinine increased, Blood urea increased, Diplopia, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Leukoencephalomyelitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow with no penetration or aspiration. Admission CBC unremarkable. CMP with normal BUN and Creatinine with elevations beginning 8/16/07: BUN 20-57, Creatinine 1.8-3.8. Serum glucose elevations began 8/17/07. CSF with (+) RBCs with (+) oligoclonal bands. CSF MBP 7.76. CSF culture (-). No fungi in CSF. CSF HSV (-).Phytanic and Pristanic Acids WNL. Urine creatinine 52. UA with 1+ bacteria. UC (+) for Gram - bacillus and staph species. Tox screen (-).
CDC 'Split Type': TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solumedrol and Prednisone taper started with improvement in all sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.


Changed on 8/14/2018

VAERS ID: 295507 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Ataxia, Azotaemia, Blood creatinine increased, Blood urea increased, Diplopia, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Leukoencephalomyelitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow with no penetration or aspiration. Admission CBC unremarkable. CMP with normal BUN and Creatinine with elevations beginning 8/16/07: BUN 20-57, Creatinine 1.8-3.8. Serum glucose elevations began 8/17/07. CSF with (+) RBCs with (+) oligoclonal bands. CSF MBP 7.76. CSF culture (-). No fungi in CSF. CSF HSV (-).Phytanic and Pristanic Acids WNL. Urine creatinine 52. UA with 1+ bacteria. UC (+) for Gram - bacillus and staph species. Tox screen (-).
CDC 'Split Type': TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solumedrol and Prednisone taper started with improvement in all sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.


Changed on 9/14/2018

VAERS ID: 295507 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Ataxia, Azotaemia, Blood creatinine increased, Blood urea increased, Diplopia, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Leukoencephalomyelitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow with no penetration or aspiration. Admission CBC unremarkable. CMP with normal BUN and Creatinine with elevations beginning 8/16/07: BUN 20-57, Creatinine 1.8-3.8. Serum glucose elevations began 8/17/07. CSF with (+) RBCs with (+) oligoclonal bands. CSF MBP 7.76. CSF culture (-). No fungi in CSF. CSF HSV (-).Phytanic and Pristanic Acids WNL. Urine creatinine 52. UA with 1+ bacteria. UC (+) for Gram - bacillus and staph species. Tox screen (-).
CDC 'Split Type': TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solumedrol and Prednisone taper started with improvement in all sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.


Changed on 10/14/2018

VAERS ID: 295507 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Texas
Vaccinated:2007-07-24
Onset:2007-08-07
Submitted:2007-08-30
Entered:2007-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Ataxia, Azotaemia, Blood creatinine increased, Blood urea increased, Diplopia, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Leukoencephalomyelitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia, abnormal LFT''s, acanthosis, overweight. PMH: Fx forearm, allergies, possible LFT abnormalities. NKDA.
Allergies:
Diagnostic Lab Data: MRI brain - abnormal findings in mid brain and base of brain; Increased BUN/CR. Labs and Diagnostics: MRI brain markedly abnormal findings involving midbrain and base of the brain. CT brain unremarkable. Renal US normal. Barium swallow with no penetration or aspiration. Admission CBC unremarkable. CMP with normal BUN and Creatinine with elevations beginning 8/16/07: BUN 20-57, Creatinine 1.8-3.8. Serum glucose elevations began 8/17/07. CSF with (+) RBCs with (+) oligoclonal bands. CSF MBP 7.76. CSF culture (-). No fungi in CSF. CSF HSV (-).Phytanic and Pristanic Acids WNL. Urine creatinine 52. UA with 1+ bacteria. UC (+) for Gram - bacillus and staph species. Tox screen (-).
CDC 'Split Type': TX0791

Write-up: Pt presented to the clinic on 8/13/07 with 1 week history of diplopia, ataxia, and weakness of extremities R$gL. Pt was admitted to hospital on 8/14 and dx with acute disseminated encephalomyelitis and azotemia. Pt was treated with a 5 day course of Solumedrol and Prednisone taper started with improvement in all sx''s except diplopia. 12/26/2007 MR received for DOS 8/14-24/2007. No formal D/C DX noted but following diagnostic studies DX of ADEM is proposed. Child presented to ER with 6 day hx of double vision, 4 day hx of unsteady gait, extremity weakness (R$gL) and abnormal eye movements noted by dad. Pt began running into things and falling while walking. Weakness, pain and unsteady gait have worsened. PE (+) for decreased strength upper & lower extremities, 1 beat clonus bilat, CN III palsy, R exotropia. Neurologic sequelae: Pt became more encephalopathic during admission (ataxia and III CN palsy) so transfered to PICU. Pt developed deteriorating renal function/azotemia which worsened after CT contrast. Txd with IV and po steroids. Discharged on day 10 in stable condition with aspiration precautions. 12/28/2007 Spoke with reporter who states only sequelae at this time is some occasional double vision when pt gets tired. Other sx such as ataxia, dysphagia and renal function are now resolved.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=295507&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166