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This is VAERS ID 310113

(NOTE: This result is from the 8/31/2010 version of the VAERS database)

Case Details

VAERS ID: 310113 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: Foreign  
Vaccinated:2008-04-02
Onset:2008-04-06
   Days after vaccination:4
Submitted: 2008-04-18
   Days after onset:12
Entered: 2008-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (TRITANRIX) / GLAXOSMITHKLINE BIOLOGICALS AT15B8338A / - RL / UN
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS A72CA204A / - RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA447B / - - / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal distension, Abdominal pain, Anuria, Catheter placement, Computerised tomogram abnormal, Enema administration, Intestinal resection, Intussusception, Surgery, Ultrasound abdomen abnormal, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan, 06Apr2008, intussusceptunit; Ultrasound abdomen, 06Apr2008, intussusceptunit
CDC Split Type: b0516016A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with Rotarix (GlaxoSmithKline). Previous and/or concurrent vaccination included Hiberix; GlaxoSmithKline; right thigh given on 18 February 2008 and 2 April 2008; Tritanrix; GlaxoSmithKline; right thigh given on 18 February 2008 and 2 April 2008; oral poliomyelitis vaccine; non-GSK manufacturer; oral given on 18 February 2008. On 2 April 2008, the subject received 1st dose of Rotarix (oral). On 6 April 2008, 4 days after vaccination with Rotarix, the subject experienced abdominal cramp with vomiting. The subject was brought to hospital where the clinical examination showed a distended abdomen. Abdomen ultrasound and CT scan revealed an intussusception. Water enema was performed twice without success. The subject was hospitalised. On 7 April 2008, at surgery, an ileocolic intussusception was found and bowel resection was performed. After surgery, the subject experienced anuria with urinary crystals following catheter in bladder. He was readmitted to hospital for a bladder washout. At the time of reporting the outcome of the events was unspecified.


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