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This is VAERS ID 319717

Case Details

VAERS ID: 319717 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Male  
Location: Kentucky  
Vaccinated:2008-07-02
Onset:2008-07-10
   Days after vaccination:8
Submitted: 2008-07-19
   Days after onset:9
Entered: 2008-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2934BA / 3 LL / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF373AB / 3 LL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C457211L / 3 RL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0211X / 3 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium double contrast, Intussusception
SMQs:, Gastrointestinal obstruction (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: eczema. NKDA
Allergies:
Diagnostic Lab Data: air enema diagnosed and treated the condition. Labs and Diagnostics: Abd X-ray (+) dilated bowel loops, Abd US (+) for IS in mid transverse colon. Air contrast enema (+) for IS. CBC WNL.
CDC Split Type:

Write-up: intussusception. 08/26/2008 MR received for DOS 7/10-11/2008 with D/C DX: Intussusception. Pt presented with 1 day hx of blood in stool and abdominal pain, fever, fussiness, nausea and vomiting. PE (+) for abdominal tenderness and guarding. Sent for air enema reduction following US (+) for IS. Reduction successful. D/C next day.


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