| VAERS ID: |
43597 (history) |
| Form: |
Version 1.0 |
| Age: |
0.4 |
| Sex: |
Male |
| Location: |
California |
| Vaccinated: | 1991-10-08 |
| Onset: | 1991-10-08 |
| Days after vaccination: | 0 |
| Submitted: |
1992-07-10 |
| Days after onset: | 276 |
| Entered: |
1992-07-20 |
| Days after submission: | 10 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
0522V / 2 |
LL / IM |
Administered by: Private Purchased by: Private
Symptoms: Pyrexia,
Sepsis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: mom said felt sl warm noc a/
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: culture of blood, urine, CSF;
CDC Split Type:
Write-up: fever 104 hosp for r/o sepsis; |
