National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 389456

Case Details

VAERS ID: 389456 (history)  
Form: Version 1.0  
Age: 0.14  
Sex: Unknown  
Location: Foreign  
Vaccinated:2010-01-06
Onset:2010-01-11
   Days after vaccination:5
Submitted: 2010-05-26
   Days after onset:134
Entered: 2010-05-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (INFANRIX HEXA) / GLAXOSMITHKLINE BIOLOGICALS 020CA635A / UNK UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D28551 / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA987A / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood culture negative, Body temperature decreased, Gastrointestinal hypomotility, Gastrointestinal inflammation, Haematochezia, Hypotonic-hyporesponsive episode, Intussusception, Peritoneal disorder, Rash maculo-papular, Sepsis, Ultrasound abdomen abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific inflammation (broad), Ischaemic colitis (broad), Hypotonic-hyporesponsive episode (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concomitant medications were not reported.
Current Illness:
Preexisting Conditions: Relevant medical history was not provided.
Allergies:
Diagnostic Lab Data: Body temperature (results: 35.9 deg. C.) was done on 11-Jan-2010. Additionally, blood culture (results: negative) and ultrasound abdomen (results: revealed multiple distended bowel loops with sluggish peristalsis and minimal free fluid in the peritoneal cavity) were done on an unspecified date.
CDC Split Type: PLWYEH15265210

Write-up: Information regarding PREVENAR was received from a physician (case ID: N128/2010) regarding an 8-week-old patient who experienced hypotonic-hyporesponsive episode, rash maculo-papular, body temperature decreased, intussusception, intestinal hyperemia, peritoneal disorder, stool bloody and bowel peristalsis decreased. The patient received a dose on 06-Jan-2010. The patient also received a dose of ROTARIX (GlaxoSmithKline) and a dose of INFANRIX HEXA on 06-Jan-2010. On 11-Jan-2010 the patient experienced hypotonic-hyporesponsive episode, rash maculo-papular, body temperature decreased, intussusception, intestinal hyperemia, peritoneal disorder, stool bloody and bowel peristalsis decreased. The child was hospitalised in Hospital A and then transferred to the Hospital for Infection Diseases due to suspicion of sepsis. The child required receiving KKC (?). Intussusception resolved spontaneously. The patient was recovering from hypotonic-hyporesponsive episode, rash maculo-papular, body temperature decreased, intestinal hyperemia, peritoneal disorder, stool bloody and bowel peristalsis decreased at the time of this report. No additional information was available at the time of this report.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=389456


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166