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This is VAERS ID 319862

Case Details

VAERS ID: 319862 (history)  
Form: Version 1.0  
Age: 0.34  
Sex: Male  
Location: California  
Vaccinated:2008-04-07
Onset:2008-05-22
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2008-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B060AB / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0127 / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C57539 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1598U / 2 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Intussusception, Laparoscopy
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: CT scan (+) for IS. Contrast enema (+) for IS. Abd X-ray suspicious for IS. CBC and Chem unremarkable.
CDC Split Type:

Write-up: Patient had intussusception on or before 5/24/08. Over a month after his second dose of rotavirus vaccine, he had failed reduction in a local facility, hence sent to hospital for laparoscopic reduction. 07/28/2008 MR received for DOS 5/23-24/2008 with D/C DX: Intussusception. Infant presented following transfer from another hospital with diarrhea, vomiting blood, blood in stool and decreased activity. PE (+) for a mass in the abdomen and rash. Contrast enema x 2 unable to fully reduce IS and pt taken to OR for Laparoscopic reduction of IS with appendectomy. F/U visit 6/9/08-doing well post-op. Labs and Diagnostics: CT scan (+) for IS. Contrast enema (+) for IS. Abd X-ray suspicious for IS. CBC and Chem unremarkable. 07/28/2008 MR received for DOS 5/23-24/2008 with D/C DX: Intussusception. Infant presented following transfer from another hospital with diarrhea, vomiting blood, blood in stool and decreased activity. PE (+) for a mass in the abdomen and rash. Contrast enema x 2 unable to fully reduce IS and pt taken to OR for Laparoscopic reduction of IS with appendectomy. F/U visit 6/9/08-doing well post-op.


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