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This is VAERS ID 382144

Case Details

VAERS ID: 382144 (history)  
Form: Version 1.0  
Age: 0.18  
Sex: Female  
Location: North Carolina  
Vaccinated:2010-02-19
Onset:2010-03-08
   Days after vaccination:17
Submitted: 2010-03-09
   Days after onset:1
Entered: 2010-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U3009BA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF745AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR D04132 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D87187 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1180Y / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Barium enema, Blood culture, Full blood count, Intussusception, Laboratory test, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal obstruction (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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.
Allergies:
Diagnostic Lab Data: BARIUM ENEMA, CBC, CHEM 7, BLOOD CULTURE.
CDC Split Type:

Write-up: INTUSSUSCEPTION, FEVER.


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