National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 300041

Case Details

VAERS ID: 300041 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Female  
Location: Nebraska  
Vaccinated:2007-12-10
Onset:2007-12-13
   Days after vaccination:3
Submitted: 2007-12-17
   Days after onset:4
Entered: 2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C27690AA / 3 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0273 / 3 RL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B540168 / 3 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1108U / 3 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Urinary system X-ray, X-ray gastrointestinal tract, X-ray with contrast upper gastrointestinal tract
SMQs:, Gastrointestinal obstruction (narrow)

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None 1/22/08-records received-viral infection requiring breathing treatments and steroids.
Allergies:
Diagnostic Lab Data: UGI and KUB as well as a barium enema was done. 12/31/07-records received-Two view abdomen x-ray normal bowel gas pattern. 1/22/08-records received-Upper GI series-normal with single episode of aspiration. Abdominal x-ray-intussusception. Air Enema with residual contrast-intussusception mid transverse colon. Surgery exploratory laparotomy and appendectomy. WBC 15.91, neutrophil 78.0, sodium 135, BUN 4. 4/15/08-Path report received 2/13/08-appendix with adenovirus infection. positive immunohistochemical evidence of adenovirus. No immunohistochemical evidence of rotovirus. krk
CDC Split Type:

Write-up: Had an intussusception 3 days after the Rotateq was given. Pt did require surgery to reduce it. 12/31/07-records received for DOS 12/13/07-ER visit C/O choking on sputum, coughs up yellowish color sputum. 1/22/08-records received for DOS 12/13-12/16/07-DC DX: Intussusception. Presented with 1 day history of nausea and vomiting.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=300041


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