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This is VAERS ID 304268

Case Details

VAERS ID: 304268 (history)  
Form: Version 1.0  
Age: 0.31  
Gender: Male  
Location: Alabama  
Vaccinated:2008-02-01
Onset:2008-02-02
   Days after vaccination:1
Submitted: 2008-02-04
   Days after onset:2
Entered: 2008-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B128AB / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF213AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54013F / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0969U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Diarrhoea haemorrhagic, Enema administration, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: DRY PATCHES ON SKIN, SNEEZING
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal ultrasound, Barium enema, Stool culture, Stool O&P and Stool for rotavirus 2/25/08-records received-US demonstrated intussusception. Air contrast enema showed evidence of a resolved intussusception. Stool hemoccult positive. Stool positive for Salmonella group B.
CDC Split Type:

Write-up: Patient presented to ER on 2/2/08 with vomiting, bloody diarrhea; had Abdominal U/S which showed intussusception which was followed by a barium enema which showed resolution of intussusception, still in hospital as of today 2/4/2008. 2/22/08-records received for DOS 2/3-2/4/08-Gastroenteritis with hematochezia resolved intussusception. C/O diarrhea 2/2/08, watery stools. Vomiting and blood noted in stool. Fussy.


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