National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 333395

Case Details

VAERS ID: 333395 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: California  
Vaccinated:2008-09-26
Onset:2008-11-20
   Days after vaccination:55
Submitted: 2008-11-26
   Days after onset:6
Entered: 2008-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B156DA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF403AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C87339 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0302X / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Intussusception, Surgery
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: RANITIDINE
Current Illness: NONE
Preexisting Conditions: GASTROESOPHAGEAL REFLUX DISEASE. PMH: GERD
Allergies:
Diagnostic Lab Data: surgical reduction of intussusception. Labs and Diagnostics: Abd X-ray (+) for decreased gas in distal colon/rectum. BE (+) for IS. CBC with 18.3 WBCs-82% segs, 15% lymphs, 3% monos.
CDC Split Type:

Write-up: Intussusception. 01/06/2009 MR received for DOS 11/20-23/2008 with D/C DX: Intussusception. Pt initially presented to PCP with c/o bilious emesis x3, refusing po, irritability and crying. Pale, mottled and lethargic. Sent to ER for transport to higher level of care. PE (+) for decreased activity, back arching, abdominal tenderness, single macule on suprapubic skin. IS (+) on BE but unable to reduce. Taken to OR for Irreducible Ileocolic IS-laparoscopy. Reduction of IS. Appendectomy. Post-op uneventful and d/c home.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=333395


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166