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This is VAERS ID 323614

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 323614
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C80880 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema abnormal, Chest X-ray normal, Bacteria stool identified, Angiogram

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''''s eyes would r"oll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx


Changed on 12/8/2009

VAERS ID: 323614 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C80880 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema abnormal, Chest X-ray normal, Computerised tomogram abnormal, Convulsion, Diarrhoea haemorrhagic, Electroencephalogram abnormal, Full blood count, Haematocrit decreased, Haemoglobin decreased, Intussusception, Laparotomy, Lethargy, Lumbar puncture normal, Microcytic anaemia, Nuclear magnetic resonance imaging brain abnormal, Small intestinal intussusception reduction, Somnolence, Tongue disorder, Tremor, Urinary system X-ray, Vomiting, Wheezing, Postictal state, Enema administration, Ultrasound abdomen abnormal, Gaze palsy, Bacteria stool identified, Scan brain, Angiogram

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''''s Pt''s eyes would r"oll roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 3/2/2010

VAERS ID: 323614 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC C80880 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema abnormal, Chest X-ray normal, Computerised tomogram abnormal, Convulsion, Diarrhoea haemorrhagic, Electroencephalogram abnormal, Full blood count, Haematocrit decreased, Haemoglobin decreased, Intussusception, Laparotomy, Lethargy, Lumbar puncture normal, Microcytic anaemia, Nuclear magnetic resonance imaging brain abnormal, Small intestinal intussusception reduction, Somnolence, Tongue disorder, Tremor, Urinary system X-ray, Vomiting, Wheezing, Postictal state, Enema administration, Ultrasound abdomen abnormal, Gaze palsy, Bacteria stool identified, Scan brain, Angiogram

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 4/7/2010

VAERS ID: 323614 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 RL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C80880 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema abnormal, Chest X-ray normal, Computerised tomogram abnormal, Convulsion, Diarrhoea haemorrhagic, Electroencephalogram abnormal, Full blood count, Haematocrit decreased, Haemoglobin decreased, Intussusception, Laparotomy, Lethargy, Lumbar puncture normal, Microcytic anaemia, Nuclear magnetic resonance imaging brain abnormal, Small intestinal intussusception reduction, Somnolence, Tongue disorder, Tremor, Urinary system X-ray, Vomiting, Wheezing, Postictal state, Enema administration, Ultrasound abdomen abnormal, Gaze palsy, Bacteria stool identified, Scan brain, Angiogram

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 8/31/2010

VAERS ID: 323614 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH C80880 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema abnormal, Chest X-ray normal, Computerised tomogram abnormal, Convulsion, Diarrhoea haemorrhagic, Electroencephalogram abnormal, Full blood count, Haematocrit decreased, Haemoglobin decreased, Intussusception, Laparotomy, Lethargy, Lumbar puncture normal, Microcytic anaemia, Nuclear magnetic resonance imaging brain abnormal, Small intestinal intussusception reduction, Somnolence, Tongue disorder, Tremor, Urinary system X-ray, Vomiting, Wheezing, Postictal state, Enema administration, Ultrasound abdomen abnormal, Gaze palsy, Bacteria stool identified, Scan brain, Angiogram

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 5/13/2013

VAERS ID: 323614 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema abnormal, Chest X-ray normal, Computerised tomogram abnormal, Convulsion, Diarrhoea haemorrhagic, Electroencephalogram abnormal, Full blood count, Haematocrit decreased, Haemoglobin decreased, Intussusception, Laparotomy, Lethargy, Lumbar puncture normal, Microcytic anaemia, Nuclear magnetic resonance imaging brain abnormal, Small intestinal intussusception reduction, Somnolence, Tongue disorder, Tremor, Urinary system X-ray, Vomiting, Wheezing, Postictal state, Enema administration, Ultrasound abdomen abnormal, Gaze palsy, Bacteria stool identified, Scan brain, Angiogram

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 4/14/2017

VAERS ID: 323614 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema abnormal, Chest X-ray normal, Computerised tomogram abnormal, Convulsion, Diarrhoea haemorrhagic, Electroencephalogram abnormal, Full blood count, Haematocrit decreased, Haemoglobin decreased, Intussusception, Laparotomy, Lethargy, Lumbar puncture normal, Microcytic anaemia, Nuclear magnetic resonance imaging brain abnormal, Small intestinal intussusception reduction, Somnolence, Tongue disorder, Tremor, Urinary system X-ray, Vomiting, Wheezing, Postictal state, Enema administration, Ultrasound abdomen abnormal, Gaze palsy, Bacteria stool identified, Scan brain, Angiogram

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US suggestive of IS. Abd CT (+) for Ileo-colonic IS with severe small bowel dilitation. Barium enema (+) for IS. CBC with Hgb 9.7, Hct 30.1. EEG abnormal but suboptimal.
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 9/14/2017

VAERS ID: 323614 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 1 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 2 - MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US suggestive of IS. Abd CT (+) for Ileo-colonic IS with severe small bowel dilitation. Barium enema (+) for IS. CBC with Hgb 9.7, Hct 30.1. EEG abnormal but suboptimal.
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 2/14/2018

VAERS ID: 323614 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US suggestive of IS. Abd CT (+) for Ileo-colonic IS with severe small bowel dilitation. Barium enema (+) for IS. CBC with Hgb 9.7, Hct 30.1. EEG abnormal but suboptimal.
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 6/14/2018

VAERS ID: 323614 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US suggestive of IS. Abd CT (+) for Ileo-colonic IS with severe small bowel dilitation. Barium enema (+) for IS. CBC with Hgb 9.7, Hct 30.1. EEG abnormal but suboptimal.
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 8/14/2018

VAERS ID: 323614 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US suggestive of IS. Abd CT (+) for Ileo-colonic IS with severe small bowel dilitation. Barium enema (+) for IS. CBC with Hgb 9.7, Hct 30.1. EEG abnormal but suboptimal.
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 9/14/2018

VAERS ID: 323614 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US suggestive of IS. Abd CT (+) for Ileo-colonic IS with severe small bowel dilitation. Barium enema (+) for IS. CBC with Hgb 9.7, Hct 30.1. EEG abnormal but suboptimal.
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


Changed on 10/14/2018

VAERS ID: 323614 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:2008-07-17
Onset:2008-07-28
Submitted:0000-00-00
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US suggestive of IS. Abd CT (+) for Ileo-colonic IS with severe small bowel dilitation. Barium enema (+) for IS. CBC with Hgb 9.7, Hct 30.1. EEG abnormal but suboptimal.
CDC 'Split Type':

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.

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