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This is VAERS ID 43115

Case Details

VAERS ID: 43115 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Female  
Location: California  
Vaccinated:1992-05-12
Onset:1992-05-14
   Days after vaccination:2
Submitted: 1992-06-16
   Days after onset:33
Entered: 1992-06-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0119V / 1 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Agitation, Coordination abnormal, Delirium, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC Split Type:

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


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