| VAERS ID: |
51238 (history) |
| Form: |
Version 1.0 |
| Age: |
1.4 |
| Sex: |
Male |
| Location: |
Foreign |
| Vaccinated: | 1992-05-19 |
| Onset: | 1992-05-22 |
| Days after vaccination: | 3 |
| Submitted: |
0000-00-00 |
| Entered: |
1993-03-29 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
46882 / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Hypotension,
Infection,
Meningitis,
Muscle twitching,
Mydriasis,
Respiratory disorder,
Sepsis,
Tachycardia
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Noninfectious meningitis (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)
Life Threatening? Yes
Birth Defect? No
Died? Yes
Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES92125124
Write-up: Pt recvd vax MAY92 & on 22MAY92 pt temp rose to 104 & vomited 4 times in 3 hrs; hydrated & chest clear; pt admited to hosp where died of meningococcal meningitis; |
