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This is VAERS ID 39342

Case Details

VAERS ID: 39342 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Female  
Location: Washington  
Vaccinated:1991-12-04
Onset:1991-12-31
   Days after vaccination:27
Submitted: 1992-01-08
   Days after onset:8
Entered: 1992-02-04
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316976 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1140T / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0641H / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Hostility/aggression (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, 5 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC Split Type: WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


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