National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 351972

Case Details

VAERS ID: 351972 (history)  
Age: 13.0  
Gender: Female  
Location: Georgia  
Vaccinated:2007-11-13
Onset:2007-12-07
   Days after vaccination:24
Submitted: 2009-07-20
   Days after onset:590
Entered: 2009-07-21
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / 0 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain upper, Activities of daily living impaired, Arthralgia, Asthenia, CSF protein increased, Dyspnoea, Fatigue, Headache, Lumbar puncture, Muscular weakness, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Ear tube insertion; Adenoidectomy. 8/6/09 Multiple hospital inpatient, DC summary, and ER records. Ear infection, tonsillectomy, adenoidectomy. Recent URI. PMH: Pharyngitis. OM. Diarhea. HSV1. Hand pain. weight gain. Dysthymic disorder . Ear tubes. Family hx of CMT.
Diagnostic Lab Data: Spinal tap, there was protein in the spinal fluid. 8/6/09 Multiple hospital inpatient, DC summary, and ER records. LABS and DIAGNOSTICS: CBC - WBC 2.61 K/mm3 (L) Mono 14% (H). Urinalysis - protein trace, blood trace, WBC 6 /hpf (H), RBC 13 /hpf (H). CHEM - Glucose 122 mg/dL (H). CRP 1.030 mg/dL (H). Blood Culture - No Growth. Chest X-ray - Mild thoracolumbar dextroscoliosis. LABS and DIAGNOSTICS: CT Head - Normal. CBC - WBC 3.73 K/mm3 (L) HCT 34.8% (L) PLT 123 K/mm3 (L) PMN 17% (L) Band 14% (H) Lymph 59% (H) Lumbar Puncture - CSF Protein 86.0 mg/dL (H). CHEM - Glucose 100 mg/dL (H) Total Protein Serum 6.0 g/dL (L) Albumin Serum 3.3 g/dL (L) Alk Phos 191 U/L (H) AST 68 U/L (H) ALT 74 U/L (H). Numerous bacterial and viral serologies and cultu
CDC Split Type: WAES0907USA01998

Write-up: Information has been received from a consumer concerning a 14 years old female with a history of tubes in ears when little and adenoids removed at age 2 years old and no drug reactions who on 13-NOV-2007 was vaccinated with the first dose of GARDASIL. There was no concomitant medication. The patient received the 2nd dose of GARDASIL on 16-JAN-2008 and the 3rd dose of GARDASIL on 23-MAY-2008. At the beginning of February 2009, the patient experienced weakness, pain, tiredness, terrible leg pain, shortness of breath, muscle weakness, every now and then the stomach bothers her, fever, and headache. The patient had been seen in the office and hospitalized. The patient has been in and out of the hospital. The unspecified physicians at the hospital thought the patient had Guillain Barre but later determined it is not. Two spinal taps, 3 CT scans, MRI, numerous X-rays and blood panels were performed. The results showed that there was protein in the spinal fluid. The patient is better but every now and then there is muscle weakness and joint pain throughout both arms, both legs and both feet. The patient was homebound for the rest of the school year and missed school from February to March in 2009. The patient was at the hospital with 17 different physicians. Weakness, pain, tiredness, terrible leg pain, shortness of breath, muscle weakness, stomach bothers her, fever, headache and joint pain throughout both arms, legs and feet were considered to be disabling and immediately life-threatening. Follow-up information has been received from a medical assistant concerning a 14 years old female who on 13-NOV-2007 was vaccinated with the first dose of GARDASIL (lot# 657737/0522U). The patient received the 2nd dose of GARDASIL (lot# 657737/0522U) on 16-JAN-2008 and the 3rd dose of GARDASIL (lot# 658094/0524U) on 23-MAY-2008. No other vaccines were administered at the time of the GARDASIL dose. A lot check has been initiated. Additional information has been requested. 7/24/09 MR received from PCP from 11/2007 to 4/13/09. In for sick visit 11/13/07 with c/o sore throat. DX: Fever HPV vax #1 given. Returned 12/7/07 with c/o back pain, body aches. Had been moving heavy boxes. DX: Pain Elbow. Shoulder Joint pain. PT had UA and dx with UTI. Returned 1/16/08 with c/o R ear pain. R TM bulging. DX: OM HPV#2 given. Several OVs for sore throat cough.DX: Pharyngitis, Acute. 3rd HPV 5/23/08 Continued ear pain with multiple visits. Knee pain 10/2008. Several ER visits for fever, dehydration, leg pain and swelling 3/2009. Later H/A. DX: Lymphadenopathy, H/A. Mononucleosis, infectious. Hospital f/u 4/3/09 for weakness and paresthesias. DX: Weight loss. GBS. Parent report 4/13/09 that pt has been falling a lot and has tingling in feet. To F/U with neurologist. 7/22/09 Partial hospital record rec''d for DOS 3/25-28/09 with D/C DX: Charcot Marie Tooth and 5/14-09 with same. Pt presented with worsening neck pain which radiates to fingers, L hip pain which radiates to toes, weakness, numbness of feet, . Recently hospitalized for GBS vs Charcot-Marie-Tooth Disease. Recent 18 lb weight loss. PE (+) stumbling gait, (+) Romberg, decreased reflexes. Labs: LFTs elevated. CSF protein increased. MRI brain WNL. CXR WNL. Nerve conduction studies abnormal. CSF IgG (H) 15.2. CSF protein 148. CSF Albumin (H) 87.2. Serum Albumin (L) 3.1, CBC WNL. Head CT (-). Monospot (+). 8/6/09 Multiple hospital inpatient, DC summary, and ER records. ER DOS 3/6/09. Assessment: Acute febrile illness, Viral syndrome, Proteinuria, leukopenia. Patient presents with fever, shortness of breath, bilateral ear pain. Bilateral leg pain, numbness, and tingling from knee to bottom of feet. Does not feel good. Decrease in appetite. Swelling in feet and legs. Fatigue. Blurred vision and seeing spots. ER DOS 3/10/09 - 3/11/09 Assessment: Acute febrile illness, fever with meningeal signs, increased liver function tests, Bandemia. Thrombocytopenia, hyperglycemia, impacted molar. Patient


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=351972


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166