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This is VAERS ID 343296

Case Details

VAERS ID: 343296 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:595
Submitted: 2009-04-01
   Days after onset:75
Entered: 2009-04-02
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Albumin CSF increased, Angiotensin converting enzyme, Antinuclear antibody negative, Blood albumin increased, Blood lactic acid increased, CSF oligoclonal band, CSF protein increased, CSF test abnormal, Condition aggravated, Electroencephalogram normal, Encephalitis, Headache, Hemiparesis, Laboratory test, Multiple sclerosis, Neurological symptom, Nuclear magnetic resonance imaging brain abnormal, Nuclear magnetic resonance imaging normal, Red blood cells CSF positive, Sensorimotor disorder, Varicella zoster virus serology positive, Visual evoked potentials normal, Visual impairment
SMQs:, Lactic acidosis (narrow), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Current Illness: Frontal headache; Brain disorder NOS; Multiple sclerosis
Preexisting Conditions:
Diagnostic Lab Data: magnetic resonance imaging, 11Feb09, cervical and thoracic spine were normal; electroencephalography, 16Feb09, normal; visual evoked potential, normal; diagnostic laboratory test, ASI: 2.02, No confirmation of intrathecal antibody sinthesis; magnetic resonance imaging, showed several lesions centrally lacated in medulla oblongata; CSF VZV IgM Ab, 27 IU/l; CSF oligoclonal band profile, 490/3 cells; serum ACE, Normal; serum ANA, Normal; serum albumin, 7.2; cerebrospinal fluid total protein test, 49 mg/dl; serum L-lactate test, 14 mg/dl; immunoglobulin G synthesis rate
CDC Split Type: WAES0903USA04968

Write-up: Case received from foreign Health Authority on 23-MAR-2009 under HA reference no. PEI2009004813. It was reported by a physician that 17 year old female patient with a positive family anamnesis of multiple sclerosis (aunt of the patient, currently without symptoms) and medical history of preexisting left-frontal headache and left-temporal brain substance defect (probably due to an craniocerebral injury in childhood) was vaccinated with three doses of GARDASIL (Lot # not reported) in 2007 (exact dates not reported). On 08-FEB-2007 the patient was vaccinated with Tdap (manufacturer unknown), on 22-MAR-2007 with a dose of HBVAXPRO (Lot # not reported) and 18-APR-2007 with a dose of TWINRIX, Lot # not reported) and finally on 31-MAY-2007 with HAVRIX (lot # not reported). Between 15-JAN-2009 and 20-JAN-2009 she experienced visual disturbance which led to diagnosis of suspicion of clinical isolated syndrome. On 09-FEB-2009 she experienced hemilateral weakness for seconds or minutes without nausea and headache. Neurological examination and psychic exploration were normal. Findings: Cranial MRI showed several lesions centrally located in the medulla oblongata without enhancement of contrast medium. MRA on 11-FEB-2009, MRI of cervical and thoracic spine, VEF, EEG on 16-FEB-2009, tibial sep. Neurological and psychological investigations showed normal results. Routine laboratory findings were normal. CSF diagnosis: 390/3-cells (<15), total protein: 49mg/dl, lactate: 14mg/dl, detection of intrathecal IgG synthesis and oligloclonal bands, slight barrier disorder, albumin quotient: 4.2, varicella zoster IgG (CSF): 27IU/l (<4.5), ASI: 2.01 (no confirmation of intrathecal antibody synthesis). Infection serology (borrelia, varicella zoster, CMV, toxoplasmosis, mumps, measles, influenza A and B, HSV, FSME, EBV and rubella) detected no acute infection. ACE and ANA were normal. Brain stem encephalitis was diagnosed. It was discussed whether brain stem encephalitis was within a CIS or ADEM. MRI was not in favor of ADEM but could be seen within CIS. A possible differential diagnosis would be a viral brain stem encephalitis. The reporter suspected a multiple sclerosis. The patient was treated on an outpatient basis. She received URBASON in high dose (1g) and CEFTRIAXON during 5 days. Follow up examination with MRI control was planned. It was reported that multiple sclerosis, sensorimotor, encephalitis and neurological symptoms were considered other important medical events. Other business partner numbers include E2009-02498. Additional information has been requested.

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