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This is VAERS ID 312391

Case Details

VAERS ID: 312391 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: Oregon  
Vaccinated:2007-12-18
Onset:2008-05-08
   Days after vaccination:142
Submitted: 2008-05-15
   Days after onset:7
Entered: 2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 3 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 3 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood test, Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, 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? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC Split Type:

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


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