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This is VAERS ID 341098

Case Details

VAERS ID: 341098 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: California  
Vaccinated:2008-12-08
Onset:2009-01-02
   Days after vaccination:25
Submitted: 2009-03-04
   Days after onset:61
Entered: 2009-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3240AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C83143 / 3 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0593X / 2 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Culture stool, 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? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Ultrasound, stool culture 3/11/09-records received-US demonstrated intussusception and x-ray with air enema reduction. 3/17/09-records received-KUB and US showed intussusception.
CDC Split Type:

Write-up: Pt experienced vomiting and 1 bloody stool. He was taken to ED where they found he had intussusception. He was treated w/air enema. He was observed for 8 hrs w/o any reoccurance and then released. 3/11/09-records received for DOS 1/6/09-follow up after ER visit for C/O vomiting times 2 days on 1/2/09- 3/17/09-records received for DOS 1/2-1/3/09-DC DX: Intussusception. Presented with 1 day history of vomitng and one bloody stool, abdominal pain, fussy, irritability. Successful reduction via air enema.


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