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This is VAERS ID 312127

Case Details

VAERS ID: 312127 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Maryland  
Vaccinated:2008-03-11
Onset:2008-04-04
   Days after vaccination:24
Submitted: 2008-05-12
   Days after onset:38
Entered: 2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Appendicectomy, Intussusception, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception.
CDC Split Type:

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


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