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This is VAERS ID 324159

Case Details

VAERS ID: 324159 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Female  
Location: Alabama  
Vaccinated:2008-07-14
Onset:2008-09-02
   Days after vaccination:50
Submitted: 2008-09-03
   Days after onset:1
Entered: 2008-09-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2934BA / 1 LL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1884U / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF373AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A12182 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C65042 / 1 UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0407X / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Enema administration, Haematochezia, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium enema LABS: abdominal US revealed ileocolic IS & air contrast enema reduced it. WBC 14.55(N), neutros 65.2%(H), lymphs 28.1%(L), plts 471(H). Chloride 112(H), BUN 3(L), albumin 3.1(L).
CDC Split Type:

Write-up: Intussusception - reduced by air contrast enema (did not require surgery). Had vomiting/blood in stool - sent to hospital for treatment. 11/7/08 Reviewed hospital medical records of 9/2-9/3/2008. FINAL DX: Intussusception Records reveal patient experienced vomiting & bloody stools x 1 day. Seen by PCP & was to be sleepy & lethargic. Admitted for observation s/p reduction of IS. Progressed well & d/c to home.


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