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This is VAERS ID 356323

Case Details

VAERS ID: 356323 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: New Mexico  
   Days after vaccination:47
Submitted: 2009-08-25
   Days after onset:765
Entered: 2009-09-02
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Aggression, Asthenia, Brain injury, Convulsion, Heart rate increased, Hypoaesthesia, Insomnia, Pain, Skin discolouration
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 123 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Type I DM; Mild cerebral palsy but was an honor student. 9/14/09 Hospital records received DOS 3/13/08 to 7/15/08. Mild spastic diplegia cerebral palsy. Insulin-dependent diabetes mellitus.
Diagnostic Lab Data: 9/14/09 Hospital records received DOS 3/13/08 to 7/15/08. LABS and DIAGNOSTICS: Thyroid Ultrasound - Normal. TSH -Normal. Thyroid Peroxides Antibodies 66.1 elevated. EEG - Abnormal. MRI Brain - Abnormal. CBC - MCV 94 (H) RDWC 14.6% (H) Neutrophil 68% (H). Sed Rate 21 mm/hr (H). C-reactive Protein 1.1 mg/dL (H). CHEM - NA 135 mmol/L (L) K 5.5 mmol/L (H) Glucose 538 mg/dL (H) BUN 31 mg/dL (H) Creatinine 0.47 mg/dL (L) Bilirubin 1.1 mg/dL (H) Chol 226 mg/dL (H) LDL Chol 149 mg/dL (H). PCO2 34 mmHg (L) PO2 64 mmHg (H) LABS and DIAGNOSTICS: Lumbar Puncture - Oligoclonal bands (+). Blood glucose 157-300 (H). Rubeola IgG Antibody (+). HSV IgG (+). Urinalysis - 15 WBC (H). A1c 8.3 (H). Urine and Serum Amino Acids abnormal. Total T4 1.2 ug/dL (L). Total T3 45 ng/dL (L). Free T4 0.6 ng/dL (L). Muscle Biopsy - Abnormal Type-2 Fiber Atrophy.
CDC Split Type:

Write-up: Aggression, seizures, rapid heart rate, brain damage, weakness, no sleep, changing skin color & textures, pain, numbness. 9/14/09 Hospital records received DOS 3/13/08 to 4/7/08. Assessment: Seizure activity with behavioral disorder. Insulin dependent diabetes mellitus. Patient transferred from another facility. Behavioral changes including defiance and disinhibited behaviors. Palpitations and transient sinus tachycardia. Agitation, aggression. Panic attacks. IVIG administration. 9/14/09 Hospital records received DOS 3/13/08 to 7/15/08. Additional information abstracted. Assessment: Meningoencephalitis with neurocognitive disturbance and disinhibition. Vaginal yeast infection. Patient c/o of palpitations. Emesis. Impulsive, compulsive eating behaviors. Increased lacrimation and salivation. Oral contraception. ICD-9 Codes: 345.90, 323.9, 341.9, 343.0, 293.0 307.51, 345.40, 343.9, 302.70, 312.9, 294.9, 310.1 293.84, 309.81, 296.90, 780.52, 250.92, 706.1, 274.9, 626.0 112.1 V15.81, V58.67, 313.81, 345.40, 293.89, 250.01, 298.9

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