This is VAERS ID 297249
(NOTE: This result is from the 12/8/2009 version of the VAERS database)
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| VAERS ID: | 297249 (history) | Vaccinated: | 2007-10-22 | | Age: | 77.0 | Onset: | 2007-11-07, Days after vaccination: 16 | | Gender: | Female | Submitted: | 2007-11-14, Days after onset: 7 | | Location: | Michigan | Entered: | 2007-11-19, Days after submission: 5 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: aspirin, calcium with vitamin D, Centrum, hyzaar, ocuvite, gluten, plendil, Prilosec, Zocor, terazostin | | Current Illness: | | Preexisting Conditions: hypertension; hypercholesterolemia; allergies to : amoxicillin, beta blockers, and ciproflaxacin 12/6/07-records received-PMH: UTIs, hypertension, osteoarthritis, gastric reflux, hyperlipidema. | | Diagnostic Lab Data: Spinal CT scan (11/12/07): large pericardial fluid collection; Echocardiogram (11/13/07): moderate to large pericardial present, no tamponade 12/6/07-records received- 2 D echo and CT pulmonary angiogram revealed moderaly large pericardial | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) | UNKNOWN MANUFACTURER | | | UN | UN | | VARZOS: ZOSTER (ZOSTAVAX) | MERCK & CO. INC. | | | UN | UN | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Angiogram,
Asthenia,
Atrial fibrillation,
Blood erythropoietin increased,
Chest X-ray normal,
Computerised tomogram abnormal,
Culture stool positive,
Diarrhoea,
Dyspnoea,
Echocardiogram abnormal,
Fatigue,
Fibrin D dimer increased,
Malaise,
Pericardial effusion,
Pyrexia,
Red blood cell sedimentation rate increased,
White blood cells urine positive
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
| | Write-up: Patient received influenza and Zostavax vaccines on 10/22. the next day she began to feel tired, weak, and generally not well. Over time she noticed shortness of breath with mild exertion. On admission she denied any fever, nausea, vomiting, diarrhea, abdominal pain, chest pain, headache, or neck stiffness. During hospitalization she did present with low grade fever along with previously described symptoms. A large pericardial effusion was detected upon further testing.12/06/07-records received for DOS 11/7-11/14/07- Developed diarrhea and stool leukocyte positive.Weak, low grade fever, malaise, dyspnea, atrial fibrillation. Impression: probably autoimmune phenomenon possible related to recent immunizations, Pericarditis. Per 60 day follow up: Atrial fibrillation developed during hospitalization related to acute pericarditis. Pt was discharged home 11/14/2007. Patient is still alive, had lab work 1/21/2008. |
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Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=297249
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