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This is VAERS ID 320886

Case Details

VAERS ID: 320886 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Female  
Location: California  
Vaccinated:2008-07-21
Onset:2008-07-25
   Days after vaccination:4
Submitted: 2008-07-30
   Days after onset:5
Entered: 2008-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0413X / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Abdominal X-ray, Carbon dioxide decreased, Intestinal obstruction, Intussusception, Leukocyturia, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad)

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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levsin drops PRN
Current Illness: None
Preexisting Conditions: Colic (intermittent); history of milia. PMH: none. NKDA
Allergies:
Diagnostic Lab Data: Low CO2, Leukocyturia, Abnormal Abdominal Films. Labs and Diagnostics: CBC with WBC 13, Hct 32. Electrolytes abnormal with Na+ 144, K+ 9, Cl- 114, bicarb 12. Barium enema (+) for ileocolic IS and bowel perf. Upper GI. US.
CDC Split Type:

Write-up: Patient had emesis x 5-7 episodes 4 days after ROTATEQ vaccination; diagnosed with obstruction due to INTUSSUSCEPTION; required surgery to relieve obstruction and removal of small segment of ascending colon. 08/27/2008 MR received for DOS 7/26-30/2008 with D/C DX: Intussusception. Pt presented with several day hx of vomiting with dehydration. Pt had bloody stool during eval. PE (+) for depressed fontanelle and abdominal distention. Enema attempted for reduction which resulted in a bowel perforation. Pt taken for emergent exploratory lap with small bowel resection of perforated segment with primary anastomosis. Pt developed mild ileus post-op which resolved spontaneously and diet then advanced.


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