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This is VAERS ID 532207

(NOTE: This result is from the 6/14/2014 version of the VAERS database)

Case Details

VAERS ID: 532207 (history)  
Form: Version .0  
Age: 11.0  
Gender: Male  
Location: New Mexico  
Vaccinated:2013-04-30
Onset:2013-06-18
   Days after vaccination:49
Submitted: 2014-05-28
   Days after onset:344
Entered: 2014-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0638AE / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4261AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B092DA / 0 RA / UN

Administered by: Private       Purchased by: Other
Symptoms: Abnormal weight gain, Alanine aminotransferase increased, Anion gap increased, Arthralgia, Blood alkaline phosphatase increased, Blood creatinine decreased, Blood thyroid stimulating hormone increased, Blood urea increased, Blood urea nitrogen/creatinine ratio increased, Chromaturia, Computerised tomogram abnormal, Dysuria, Eosinophil count increased, Groin pain, Heart rate increased, Hyperaesthesia, Hypochromasia, Imaging procedure, Joint crepitation, Joint swelling, Lymphadenopathy, Mean arterial pressure increased, Mean platelet volume decreased, Monocyte count increased, Muscle strain, Muscular weakness, Nerve block, Neutrophil count increased, Neutrophil percentage increased, Obesity, Pain, Platelet count increased, Protein total increased, Psychological factor affecting medical condition, Rash, Red cell distribution width decreased, Scrotal pain, Scrotal swelling, Specific gravity urine increased, Synovitis, Tenderness, Urine abnormality, Urine ketone body present, Urobilinogen urine increased, Weight bearing difficulty, X-ray of pelvis and hip abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Angioedema (broad), Lactic acidosis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Eosinophilic pneumonia (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Osteonecrosis (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (narrow), Myelodysplastic syndrome (broad), Tumour lysis syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 21 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: FOOD Allergies: tomatoes, pineapple, apples; MEDICATION Allergies: Augmentin, Bacterium, tetanus, PCN, pertussis, Cipro, morphine; Mitrial and tricuspid insufficient
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: RT hip and groin pain, unable to bear weight. Unable to touch right hip or leg. Swelling and rash to hip region. Patient was placed in the hospital for 3 weeks (6/24/13-6/26-13, 7/8/2013-7/11/2013, 7/23/2013-7/26/2013- 1st hospital) (9/11/20103-9/14/2013- 2nd hospital). Seen a number of physicians for hip and groin pain- had a number of medical images- had a nerve block x2. Did Physical therapy for a number of months- both land and water therapy. Tried HBO therapy.


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