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This is VAERS ID 318212

Case Details

VAERS ID: 318212 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Illinois  
   Days after vaccination:1
Submitted: 2008-07-03
   Days after onset:5
Entered: 2008-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 05244 / 2 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Activated partial thromboplastin time, Ammonia increased, Antithrombin III increased, Blood lactic acid normal, C-reactive protein increased, CSF culture negative, CSF glucose increased, CSF protein increased, CSF protein normal, Cardiac arrest, Cold agglutinins, Computerised tomogram normal, Electrocardiogram normal, HIV antibody negative, Headache, Intensive care, International normalised ratio, International normalised ratio increased, Mechanical ventilation, Mycoplasma serology, Myelitis transverse, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain, Pain in extremity, Paralysis, Paralysis flaccid, Protein S normal, Protein total increased, Red blood cell sedimentation rate decreased, Red blood cells CSF positive, Respiratory failure, Scan brain
SMQs:, Torsade de pointes/QT prolongation (broad), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (narrow), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 38 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: none- no herbals, other OTC medications, no prescription medications
Current Illness: none- no recent viral illness- no history of trauma
Preexisting Conditions: none
Diagnostic Lab Data: (6/28) ESR - 18, CRP <5, lactate 1.3, NH3 73 (6/30) CSF - 5wbc(2S, 83L, 15M) , 99 RBC, 103 Glu, 19 Pro - CSF for HSV, enterorvirus, westnile IgM all pending - CSF bacterial culture negative, ATIII 106, Protein C 114, Protein S 84, INR 1.2, PTT 30, HIV Ab - negative, cold agglutinin for mycoplasma Ab- pending, Spinal MRI- positive for C2-5, T2 lesion(stroke vs. meyelitis vs. demyelinating disease), EKG- nl, MRA brain- normal (upper vertebral ateries appear), CT brain- normal 8/28/08-records received-Imaging of brain and spinal cord negative. Infectious and autoimmune workups negative. 9/10/08-records received-MRI demonstrated subtle changes in C2-C4 area of spinal cord. Echo for PFO was negative. LP normal. HIV negative. Autoimmune workup negative including rheumatoid factor, ANA, double stranded DNA, SSA SSB. Viral and bacterial etiologies ruled out. C/O headaches and left ear pain most likely tension related. Chest x-ray right lower lobe pneumonia.
CDC Split Type:

Write-up: 14 year old (previously health) (no recent history of URIs or trauma)- History significant for fact that she received Gardasil at clinic on 6/27/08 (2nd dose- first dose in April 2008)- On 6/28/08 patient with acute onset severe headache, left arm pain(paralysis)- leading to parents to call 911- by the time ambulance arrived patient with flaccid paralysis and asystolic event in ambulance requiring atropine IV-- currently in ICU with bilateral upper and lower extremity paralysis and respiratory failure (ventilated)-- diagnosed with : classic transverse myelitis currently of unknown etiology8/28/08-records received-presented to ED on 6/28/08 with acute onset of flaccid paralysis, sudden onset of severe headache on day of presentation followed by arm pain. Shortly thereafter lost tone in all extremities. Intubated in field and went into asystole. Placed on ventilator. Hospital course complicated by right sided pleural effusion and pneumothorax requiring placement of chest tube. DX with aspiration pneumonia. Nasogastric tube insertion. Unable to be extubated. Respiratory alkalosis. Plasmapheresis. PE on 7/7/08 no change since admission. Dyspnea. DX:transverse myelitis of unknown etiology, intubated secondary to respiratory failure with persistent sensation of air hunger. 9/10/08-DC Summary received for DOS 6/28-8/7/08- DX:Transverse myelitis. Plasmapheresis. Etiology of transverse myelitis was negative. Re-developed temperature and deep touch sensation in extremities, three weeks after event regained deep tendon reflexes and positive Babinski sign bilaterally. Neuropathic pain. Tracheostomy and mechanical ventilation. Asystole of unknown etiology. Transferred to rehabilitation facility.

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