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This is VAERS ID 342506

Case Details

VAERS ID: 342506 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Illinois  
Vaccinated:2009-03-13
Onset:2009-03-20
   Days after vaccination:7
Submitted: 2009-03-24
   Days after onset:4
Entered: 2009-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 1794X / UNK MO / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. AC21B207BA / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Intussusception
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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prevacid
Current Illness: Yes, URI
Preexisting Conditions: GERD PMH: constipation.
Allergies:
Diagnostic Lab Data: LABS: KUB revealed dilated central bowel loops & paucity of gas in LLQ. Abdominal US (+) IS in LLQ. Air contrast enema reduced. UGI series WNL.
CDC Split Type:

Write-up: Two events of intussusception, each after given rotateq vaccine, the second episode was 7 days after the rotateq was administered. Was life flighted both times. 03/25/09 Received hospital medical records of 2/15-2/17/09 & 3/21/2009. FINAL DX: Intussusception Records reveal patient experienced irritability, emesis, bloody stools. Seen in outlying ER & transferred to higher leve of care. Tx w/IVF, antibiotics. Surgery consult done & PICU. Admitted overnight for observation s/p enema reduction of IS. Radiology noted cecum abnormally positioned in LLQ. Developed increased pain & repeat US (-) for IS. 3/21/09 records consist only of abdominal x-ray & US. X-ray revealed distention of small bowel & possibly large bowel & could not exclude IS; however, US (-) for IS. No further medical records available for this visit.


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