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This is VAERS ID 323515

Case Details

VAERS ID: 323515 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Female  
Location: Hawaii  
Vaccinated:2008-07-23
Onset:2008-08-24
   Days after vaccination:32
Submitted: 2008-08-27
   Days after onset:3
Entered: 2008-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B182AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF237AD / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C86138 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0277X / 2 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Barium enema abnormal, Intussusception, Laparoscopy, Lymphadenitis, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit A, D, C
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Ultrasound, Gastrografin enema under fluoroscopy 9/10/08-records received-Reduction of intussusception with gastrograph en enema. Labs and Diagnostics: US Abd (+) for IS in LLQ. Free fluid. Saline enema unsuccessful at reduction. Abd X-ray WNL
CDC Split Type:

Write-up: Onset 8/24/08 vomiting 9 PM. Seen at hospital where intussusception dx''ed by abd ultrasound, failed enema reduction. Transferred to another hospital where laparoscopy was done - enlarged mesenteric node was resected. 9/10/08-hospital records received for DOS 8/25-8/27/08-DC DX: Intussusception status post reduction. Dissection of large mesenteric lymph node. Laparoscopic resection of enlarged lymph node. At initial hospital, saline enema failed to reduce intussusception. Vomiting began on evening prior to admission, some blood in stools.


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