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This is VAERS ID 326343

Case Details

VAERS ID: 326343 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Male  
Location: Maryland  
Vaccinated:2008-07-17
Onset:2008-07-27
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2008-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B82AA / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF225AA / 2 RL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 1B70143E / 2 RL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0019X / 2 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Diarrhoea, Enema administration, Intussusception, Irritability, Milk allergy, Mucous stools
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Thrush, Treatment - Diflucan PO
Preexisting Conditions: Thrush, mild pulmonary artery branch stenosis PMH: eczema, PABS murmur, colic.
Allergies:
Diagnostic Lab Data: (-) Stool culture (Rotavirus) LABS: Outlying air enema c/w IS & reduced it. Outlying BE c/w IS & reduced it. Hospital abdominal x-ray revealed nonspecific distended loops of bowel w/bowel wall thickening but no IS. US x2 WNL. Stool c/s (+) salmonella
CDC Split Type:

Write-up: 7/17/08 PEDIARIX, ROTATEQ. Mucousy diarrhea (10-15 x/day) began 7/23. 7/27-clots of blood in stool/fussy, to ER, had successful reduction of intussusception via air-contrast enema. Admitted. Continued bloody stools/fussy, on Nutranigen, 7/24-transferred to hosp. then diagnosed as milk protein allergy, bloody stools cleared on NEOCATE. Discharged 7/31/08. 11/14/08 Reviewed hospital medical records 7/29-7/31/2008. FINAL DX: abdominal pain & bloody stools s/p intussusception enema reduction Records reveal patient experienced irritability, diarrhea, bloody stools, mucous stools, decreased activity, oral intake reduced x 4 days. Evaluated in outlying ER/hospital. Had been admitted overnight for observation s/p enema reduction & developed recurrent symptoms. Barium enema done & reduced IS. Symptoms recurred again & family requested transfer. Surgery & GI consults done. Improved & d/c to home w/outpatient GI clinic f/u.


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