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This is VAERS ID 346229

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

346229
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial


Changed on 3/2/2010

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial


Changed on 4/7/2010

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial


Changed on 1/4/2011

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics Diagnostics: Toxicology - Phenytoin level 22.5 mcg/mL (H) Phenobarb 51.1 mcg/mL (H). Chest X-ray - opacity R upper lobe. LP. CT head - post surgical changes, encephalomalacia. CBC - MCHC 33.4 gm/dL (H) RDW 11.4% (L) Neutro 84.5% (H) Lymph 10.2% (L). CSF - RBC 427 mm3 (H). CHEM - Glucose Fasting 113 mg/dL (H) Creatinine 0.5 mg/dL (L) ALK PHOS 259 IU/L (H). Urinalysis - Glucose trace. Bilateral Lower Extremity Venous Ultrasound - DVT left common femoral vein. EEG - abnormal, absence seizure. Wound culture - MRSA. MRSA PCR
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial abcess, encephalopathy, viral encephalitis, dehydration, developmental speech disorder, ventilator dependent for 2 months. 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08 Assessment: Epilepsy secondary to encephalitis. Patient transferred from another hospital for management of seizures and respiratory failure. Fever for 4 days, generalized tonic-clonic seizure with rolled back eyes, foaming and the mouth and urinary incontinence. Placed in pentobarbital coma, developed thrombus at site of central line placement, infiltraion left foot. Level of orientation fluctuates, speech slow. Operative proceedures - left frontal craniotomy, intraoperative electrocardiography, tailored left temporal lobectomy, megalo-hippocampectomy. Seizures persisted postoperatively. Readmitted for increased seizure activity beginning as slurred speech, head tilting, sometimes secondary generalization. Readmitted for continued cluster and complex seizures, suicidal ideation. drooling, staring blankly, perioral cyanosis, has fallen during seizures 7/2/09 ICD-9 Codes received. 51881, 5990, 34830, 78039, 7948, 4589, 0414


Changed on 4/13/2011

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics: Toxicology - Phenytoin level 22.5 mcg/mL (H) Phenobarb 51.1 mcg/mL (H). Chest X-ray - opacity R upper lobe. LP. CT head - post surgical changes, encephalomalacia. CBC - MCHC 33.4 gm/dL (H) RDW 11.4% (L) Neutro 84.5% (H) Lymph 10.2% (L). CSF - RBC 427 mm3 (H). CHEM - Glucose Fasting 113 mg/dL (H) Creatinine 0.5 mg/dL (L) ALK PHOS 259 IU/L (H). Urinalysis - Glucose trace. Bilateral Lower Extremity Venous Ultrasound - DVT left common femoral vein. EEG - abnormal, absence seizure. Wound culture - MRSA. MRSA PCR
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial abcess, encephalopathy, viral encephalitis, dehydration, developmental speech disorder, ventilator dependent for 2 months. 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08 Assessment: Epilepsy secondary to encephalitis. Patient transferred from another hospital for management of seizures and respiratory failure. Fever for 4 days, generalized tonic-clonic seizure with rolled back eyes, foaming and the mouth and urinary incontinence. Placed in pentobarbital coma, developed thrombus at site of central line placement, infiltraion left foot. Level of orientation fluctuates, speech slow. Operative proceedures - left frontal craniotomy, intraoperative electrocardiography, tailored left temporal lobectomy, megalo-hippocampectomy. Seizures persisted postoperatively. Readmitted for increased seizure activity beginning as slurred speech, head tilting, sometimes secondary generalization. Readmitted for continued cluster and complex seizures, suicidal ideation. drooling, staring blankly, perioral cyanosis, has fallen during seizures 7/2/09 ICD-9 Codes received. 51881, 5990, 34830, 78039, 7948, 4589, 0414


Changed on 5/13/2011

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics: Toxicology - Phenytoin level 22.5 mcg/mL (H) Phenobarb 51.1 mcg/mL (H). Chest X-ray - opacity R upper lobe. LP. CT head - post surgical changes, encephalomalacia. CBC - MCHC 33.4 gm/dL (H) RDW 11.4% (L) Neutro 84.5% (H) Lymph 10.2% (L). CSF - RBC 427 mm3 (H). CHEM - Glucose Fasting 113 mg/dL (H) Creatinine 0.5 mg/dL (L) ALK PHOS 259 IU/L (H). Urinalysis - Glucose trace. Bilateral Lower Extremity Venous Ultrasound - DVT left common femoral vein. EEG - abnormal, absence seizure. Wound culture - MRSA. MRSA PCR
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial abcess, encephalopathy, viral encephalitis, dehydration, developmental speech disorder, ventilator dependent for 2 months. 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08 Assessment: Epilepsy secondary to encephalitis. Patient transferred from another hospital for management of seizures and respiratory failure. Fever for 4 days, generalized tonic-clonic seizure with rolled back eyes, foaming and the mouth and urinary incontinence. Placed in pentobarbital coma, developed thrombus at site of central line placement, infiltraion left foot. Level of orientation fluctuates, speech slow. Operative proceedures - left frontal craniotomy, intraoperative electrocardiography, tailored left temporal lobectomy, megalo-hippocampectomy. Seizures persisted postoperatively. Readmitted for increased seizure activity beginning as slurred speech, head tilting, sometimes secondary generalization. Readmitted for continued cluster and complex seizures, suicidal ideation. drooling, staring blankly, perioral cyanosis, has fallen during seizures 7/2/09 ICD-9 Codes received. 51881, 5990, 34830, 78039, 7948, 4589, 0414


Changed on 6/11/2011

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics: Toxicology - Phenytoin level 22.5 mcg/mL (H) Phenobarb 51.1 mcg/mL (H). Chest X-ray - opacity R upper lobe. LP. CT head - post surgical changes, encephalomalacia. CBC - MCHC 33.4 gm/dL (H) RDW 11.4% (L) Neutro 84.5% (H) Lymph 10.2% (L). CSF - RBC 427 mm3 (H). CHEM - Glucose Fasting 113 mg/dL (H) Creatinine 0.5 mg/dL (L) ALK PHOS 259 IU/L (H). Urinalysis - Glucose trace. Bilateral Lower Extremity Venous Ultrasound - DVT left common femoral vein. EEG - abnormal, absence seizure. Wound culture - MRSA. MRSA PCR
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial abcess, encephalopathy, viral encephalitis, dehydration, developmental speech disorder, ventilator dependent for 2 months. 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08 Assessment: Epilepsy secondary to encephalitis. Patient transferred from another hospital for management of seizures and respiratory failure. Fever for 4 days, generalized tonic-clonic seizure with rolled back eyes, foaming and the mouth and urinary incontinence. Placed in pentobarbital coma, developed thrombus at site of central line placement, infiltraion left foot. Level of orientation fluctuates, speech slow. Operative proceedures - left frontal craniotomy, intraoperative electrocardiography, tailored left temporal lobectomy, megalo-hippocampectomy. Seizures persisted postoperatively. Readmitted for increased seizure activity beginning as slurred speech, head tilting, sometimes secondary generalization. Readmitted for continued cluster and complex seizures, suicidal ideation. drooling, staring blankly, perioral cyanosis, has fallen during seizures 7/2/09 ICD-9 Codes received. 51881, 5990, 34830, 78039, 7948, 4589, 0414


Changed on 6/14/2014

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics: Toxicology - Phenytoin level 22.5 mcg/mL (H) Phenobarb 51.1 mcg/mL (H). Chest X-ray - opacity R upper lobe. LP. CT head - post surgical changes, encephalomalacia. CBC - MCHC 33.4 gm/dL (H) RDW 11.4% (L) Neutro 84.5% (H) Lymph 10.2% (L). CSF - RBC 427 mm3 (H). CHEM - Glucose Fasting 113 mg/dL (H) Creatinine 0.5 mg/dL (L) ALK PHOS 259 IU/L (H). Urinalysis - Glucose trace. Bilateral Lower Extremity Venous Ultrasound - DVT left common femoral vein. EEG - abnormal, absence seizure. Wound culture - MRSA. MRSA PCR
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial abcess, encephalopathy, viral encephalitis, dehydration, developmental speech disorder, ventilator dependent for 2 months. 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08 Assessment: Epilepsy secondary to encephalitis. Patient transferred from another hospital for management of seizures and respiratory failure. Fever for 4 days, generalized tonic-clonic seizure with rolled back eyes, foaming and the mouth and urinary incontinence. Placed in pentobarbital coma, developed thrombus at site of central line placement, infiltraion left foot. Level of orientation fluctuates, speech slow. Operative proceedures - left frontal craniotomy, intraoperative electrocardiography, tailored left temporal lobectomy, megalo-hippocampectomy. Seizures persisted postoperatively. Readmitted for increased seizure activity beginning as slurred speech, head tilting, sometimes secondary generalization. Readmitted for continued cluster and complex seizures, suicidal ideation. drooling, staring blankly, perioral cyanosis, has fallen during seizures 7/2/09 ICD-9 Codes received. 51881, 5990, 34830, 78039, 7948, 4589, 0414


Changed on 2/14/2017

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics: Toxicology - Phenytoin level 22.5 mcg/mL (H) Phenobarb 51.1 mcg/mL (H). Chest X-ray - opacity R upper lobe. LP. CT head - post surgical changes, encephalomalacia. CBC - MCHC 33.4 gm/dL (H) RDW 11.4% (L) Neutro 84.5% (H) Lymph 10.2% (L). CSF - RBC 427 mm3 (H). CHEM - Glucose Fasting 113 mg/dL (H) Creatinine 0.5 mg/dL (L) ALK PHOS 259 IU/L (H). Urinalysis - Glucose trace. Bilateral Lower Extremity Venous Ultrasound - DVT left common femoral vein. EEG - abnormal, absence seizure. Wound culture - MRSA. MRSA PCR
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial abcess, encephalopathy, viral encephalitis, dehydration, developmental speech disorder, ventilator dependent for 2 months. 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08 Assessment: Epilepsy secondary to encephalitis. Patient transferred from another hospital for management of seizures and respiratory failure. Fever for 4 days, generalized tonic-clonic seizure with rolled back eyes, foaming and the mouth and urinary incontinence. Placed in pentobarbital coma, developed thrombus at site of central line placement, infiltraion left foot. Level of orientation fluctuates, speech slow. Operative proceedures - left frontal craniotomy, intraoperative electrocardiography, tailored left temporal lobectomy, megalo-hippocampectomy. Seizures persisted postoperatively. Readmitted for increased seizure activity beginning as slurred speech, head tilting, sometimes secondary generalization. Readmitted for continued cluster and complex seizures, suicidal ideation. drooling, staring blankly, perioral cyanosis, has fallen during seizures 7/2/09 ICD-9 Codes received. 51881, 5990, 34830, 78039, 7948, 4589, 0414


Changed on 4/14/2017

346229 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Anorexia, Antimicrobial susceptibility test resistant, Arterial thrombosis, Aspartate aminotransferase increased, Atrophy, Back pain, Blood bilirubin increased, Blood creatinine decreased, Blood glucose increased, Blood potassium increased, Brain abscess, Cellulitis, Chest X-ray abnormal, Choreoathetosis, Computerised tomogram abnormal, Convulsion, Craniotomy, Culture throat negative, Culture wound, Cyanosis, Dehydration, Developmental delay, Disorientation, Drooling, Dysarthria, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Epilepsy, Glucose urine present, Grand mal convulsion, Haematocrit decreased, Head injury, Lethargy, Lymphadenopathy, Mean cell haemoglobin concentration, Mean cell haemoglobin increased, Muscle twitching, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Photophobia, Pyrexia, Red blood cell count decreased, Red blood cells CSF positive, Respiratory failure, Speech disorder developmental, Staring, Stereotypy, Suicidal ideation, Surgery, Tachycardia, Ultrasound Doppler abnormal, Urinary incontinence, Viral infection, Viral pharyngitis, Encephalomalacia, Neutrophil percentage increased, Monocyte percentage decreased, Lymphocyte percentage decreased, Musculoskeletal stiffness, Methicillin-resistant Staphylococcus aureus test positive, Red cell distribution width increased, Red cell distribution width decreased, Computerised tomogram head, Anticonvulsant drug level above therapeutic, Gaze palsy, Urine ketone body present, Blood alkaline phosphatase increased, Laboratory test, Eye movement disorder, Drug level above therapeutic, Motor dysfunction, Skin graft, Foaming at mouth, Amino acid level increased, Oropharyngeal pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics: Toxicology - Phenytoin level 22.5 mcg/mL (H) Phenobarb 51.1 mcg/mL (H). Chest X-ray - opacity R upper lobe. LP. CT head - post surgical changes, encephalomalacia. CBC - MCHC 33.4 gm/dL (H) RDW 11.4% (L) Neutro 84.5% (H) Lymph 10.2% (L). CSF - RBC 427 mm3 (H). CHEM - Glucose Fasting 113 mg/dL (H) Creatinine 0.5 mg/dL (L) ALK PHOS 259 IU/L (H). Urinalysis - Glucose trace. Bilateral Lower Extremity Venous Ultrasound - DVT left common femoral vein. EEG - abnormal, absence seizure. Wound culture - MRSA. MRSA PCR
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial abcess, encephalopathy, viral encephalitis, dehydration, developmental speech disorder, ventilator dependent for 2 months. 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08 Assessment: Epilepsy secondary to encephalitis. Patient transferred from another hospital for management of seizures and respiratory failure. Fever for 4 days, generalized tonic-clonic seizure with rolled back eyes, foaming and the mouth and urinary incontinence. Placed in pentobarbital coma, developed thrombus at site of central line placement, infiltraion left foot. Level of orientation fluctuates, speech slow. Operative proceedures - left frontal craniotomy, intraoperative electrocardiography, tailored left temporal lobectomy, megalo-hippocampectomy. Seizures persisted postoperatively. Readmitted for increased seizure activity beginning as slurred speech, head tilting, sometimes secondary generalization. Readmitted for continued cluster and complex seizures, suicidal ideation. drooling, staring blankly, perioral cyanosis, has fallen during seizures 7/2/09 ICD-9 Codes received. 51881, 5990, 34830, 78039, 7948, 4589, 0414


Changed on 9/14/2017

346229 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-08-16
Onset:2007-09-19
Submitted:2009-05-01
Entered:2009-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 2 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Atrophy, Back pain, Convulsion, Developmental delay, Encephalitis, Lethargy, Neck pain, Nervous system disorder, Pyrexia, Respiratory failure, Musculoskeletal stiffness, Laboratory test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 100     Extended hospital stay? Yes
Previous Vaccinations: Sept ''07~HPV (Gardasil)~2~12.00~Patient
Other Medications: None 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 Keppra, Dilantin, phenobarbital, Ativan, Prevacid, Diastat, Lovenx, IV antibiotics
Current Illness: None
Preexisting Conditions: None 5/13/09-records received-PMH: ITP.
Allergies:
Diagnostic Lab Data: During hospitalization complete workup performed: Labs, spinal infections disease, genetic Hx etc.. 5/13/09-records received-Throat culture:negative. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 LABS and Diagnostics: Toxicology - Phenytoin level 22.5 mcg/mL (H) Phenobarb 51.1 mcg/mL (H). Chest X-ray - opacity R upper lobe. LP. CT head - post surgical changes, encephalomalacia. CBC - MCHC 33.4 gm/dL (H) RDW 11.4% (L) Neutro 84.5% (H) Lymph 10.2% (L). CSF - RBC 427 mm3 (H). CHEM - Glucose Fasting 113 mg/dL (H) Creatinine 0.5 mg/dL (L) ALK PHOS 259 IU/L (H). Urinalysis - Glucose trace. Bilateral Lower Extremity Venous Ultrasound - DVT left common femoral vein. EEG - abnormal, absence seizure. Wound culture - MRSA. MRSA PCR (+). 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08. LABS and DIAGNOSTICS: CT - Cerebral atrophy of cerebral hemispheres, left cortical temporal dysplasia / edema. Biochemistry - Glutamic acid 122 umoles/L correlates with seizure disorder, slight elevations of GABA and Beta-alanine. Urine Organic Acids - Ketosis metabolites detected. CHEM - Potassium 5.3 MMOL/L (H) ALT 39 IU/L (H) AST 49 IU/L (H) Bili Direct 0.6 MG/DL (H) Bili Indirect 1.2 MG/DL (H) A/G ratio 0.9 (L). CBC - RBC 3.59 /CMM (L) HCT 33.3% (L) MCH 31.5 PG (H) RDW 15.0% (H) Neut 75.1% (H) Lymph 18.9% (L) Mono 3.1% (L). Video EEG - abnormal. Functional MRI - Unremarkable. Path Report - Temporal Lobe and amygdala reveal neuronal disorganization and gliosis. MRI Brain - resection of left temporal lobe, left amygdala, left hippocampus.
CDC 'Split Type':

Write-up:Dx-encephalitis etiology unkonwn. Five weeks after administration pt experienced stiffness of neck. Neck pain, back pain, lethargy, no appetite fever for 7 days then began having seizures which lead to respiratory failure. 1 1/2 yr later seizures are ongoing & numerous developmental problems due to brain atrophy. 5/13/2009-records received-ER visit 9/22/07 presented with C/O one day history of fever, sore throat and right-sided neck pain. DX: Viral pharyngitis, right cervical adenopathy most likely due to viral etiology. Office visit 9/26/07-Fever and sore throat, stiff back and shoulders for 4 days. Tiredness, decreased appetite. No neck pain.Office visit 6/8/07-immunization visit received Gardasil, Menactra and Varicella. Assessment: viral infection, pharyngitis. 5/20/09 - ICD-9 codes received. 99669 infection and inflammatory reaction due to other internal prosthetic device/implant/graft, 3159 Unspecified delay in development, E8782 Surgical operation, anastomosis/bypass/graft, with abnormal reaction/later complication, no surgical misadventure, V1251 Personal history of venous thrombosis and embolism, Z8981 Primary hypercoagulable state, V1251 Personal history of venous thrombosis and embolism, 78039 Convulsions, 326 Late effects of intracranial abcess/pyogenic infection, 34839 Encephalopathy, 1390 Late effects of viral encephalitis, 27651 Dehydration, 3154 Developmental coordination disorder, 31539 Developmental speech disorder. 5/20/09 ED and hospital records received DOS 9/22/07 to 4/12/09 FINAL DIAGNOSIS: Seizure disorder Post vaccination: Intially presented to ED with one day history of fever, sore throat and right-sided neck pain. Then repeated ED visits due to seizures. Slurred speech, motor delay. Tachycardia. Skin graft anterior right foot, followed by cellulitis. Repeated febrile illness with photophobia. Hit her head several times. Disconjugate gaze. Facial twitching. Temporal lobectomy. Choreoathetoid movements of head. Venous thrombosis and embolism left lower extremity, intracranial abcess, encephalopathy, viral encephalitis, dehydration, developmental speech disorder, ventilator dependent for 2 months. 6/11/09 Hospital records and several discharge summaries recieved DOS 9/27/07 to 12/13/08 Assessment: Epilepsy secondary to encephalitis. Patient transferred from another hospital for management of seizures and respiratory failure. Fever for 4 days, generalized tonic-clonic seizure with rolled back eyes, foaming and the mouth and urinary incontinence. Placed in pentobarbital coma, developed thrombus at site of central line placement, infiltraion left foot. Level of orientation fluctuates, speech slow. Operative proceedures - left frontal craniotomy, intraoperative electrocardiography, tailored left temporal lobectomy, megalo-hippocampectomy. Seizures persisted postoperatively. Readmitted for increased seizure activity beginning as slurred speech, head tilting, sometimes secondary generalization. Readmitted for continued cluster and complex seizures, suicidal ideation. drooling, staring blankly, perioral cyanosis, has fallen during seizures 7/2/09 ICD-9 Codes received. 51881, 5990, 34830, 78039, 7948, 4589, 0414


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