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This is VAERS ID 368786

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 368786 (history)  
Form: Version .0  
Age: 23.0  
Gender: Female  
Location: Illinois  
Vaccinated:2009-11-10
Onset:2009-11-12
   Days after vaccination:2
Submitted: 2009-11-19
   Days after onset:7
Entered: 2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (INFLUENZA A (H1N1) 2009 MONOVALENT) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Ataxia, Back pain, Blood pressure increased, Blood test normal, Computerised tomogram normal, Drug abuse, Drug screen positive, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Malaise, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Post lumbar puncture syndrome, Vision blurred
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Drug abuse (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Hypertension (narrow), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids.
CDC Split Type:

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=368786


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