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This is VAERS ID 31184

Case Details

VAERS ID: 31184 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Male  
Location: Iowa  
Vaccinated:1991-02-20
Onset:1991-02-21
   Days after vaccination:1
Submitted: 1991-06-07
   Days after onset:105
Entered: 1991-06-11
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private       Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


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