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This is VAERS ID 320602

Case Details

VAERS ID: 320602 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Male  
Location: Foreign  
Vaccinated:2008-05-20
Onset:2008-07-18
   Days after vaccination:59
Submitted: 2008-07-28
   Days after onset:10
Entered: 2008-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Diagnostic procedure, Haematochezia, Intussusception, Mucous stools, Surgery, Urinary tract infection, Urine analysis abnormal, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Proctoscopy, Jul2008, IS; Urine analysis, Jul2008, UTI; X-ray, Jul2008, IS
CDC Split Type: B0530546A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 May 2008, the subject received the 1st (and the unique) dose of ROTARIX (oral, lot number not provided). On 18 July 2008, 59 days after vaccination with the 1st dose of ROTARIX, the subject e4xperienced the following first symptoms (abdominal pain, vomiting, blood and mucus in feces). The subject was initially diagnosed as having a urinary tract infection thanks to a simple urine test. It was treated with ROCEPHIN. On 21 July 2008, intussusception was diagnosed. The diagnostic was made thanks to symptoms evaluation, X-ray and rectoscopy. Surgery was performed on the same day and ileo-ceco-colonic invagination (15 cm) was found. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the subject was still hospitalized and the events were improved.


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