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This is VAERS ID 66768

Case Details

VAERS ID: 66768 (history)  
Form: Version 1.0  
Age: 4.0  
Sex: Male  
Location: Alabama  
Vaccinated:1994-07-27
Onset:0000-00-00
Submitted: 1994-08-05
Entered: 1994-09-19
   Days after submission:45
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3F51124 / 5 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1743W / 2 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 366957 / 4 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Azotaemia, Brain oedema, Clostridium colitis, Encephalopathy, Haemolytic anaemia, Infection, Pancreatitis haemorrhagic, Thrombocytopenia
SMQs:, Acute renal failure (narrow), Haemolytic disorders (narrow), Acute pancreatitis (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Pseudomembranous colitis (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1994-08-02
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Albuterol, Pred
Current Illness: rash
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: WBC count 34000 w/hematocrit 42, platelet 243,000, WBC differential showing 76% segs, 16% bands, 4% lymphs, 4% monos; fluid balance panel showed sodium 125, potassium 4.4, chloride 94, bicarbonate 25, BUN 9; stool specimen-E. Coli 0157:H7
CDC Split Type: AL9433

Write-up: pt recvd vax & exp abdo pain; illness began 5 days prior to admission w/onset of acute abdo cramps, vomiting, diarrhea; stools have been bloody & mucousy times 2 days, one day prior to surgery; t101 x 1 day; pt underwent appendectomy;


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