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This is VAERS ID 84303

Case Details

VAERS ID: 84303 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:1992-09-03
Onset:0000-00-00
Submitted: 1996-03-29
Entered: 1996-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Drug ineffective, Infection, Laboratory test abnormal, Lung disorder, Pleural effusion, Pneumonia, Pyrexia
SMQs:, Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Omeprazole, Bactrim, Fluconazole, Clarithromyan;
Current Illness:
Preexisting Conditions: mild hemophilia A, recvd factor vIII x 1, AIDS, hx pneumocystis carinii pneumonia OCT92; allergic to PCN
Allergies:
Diagnostic Lab Data: CD4=<10 for over 1 year; CXR ABN; abdom CT, ERCP;COD progressive pulmonary dz w/bilat pleural effusions
CDC Split Type:

Write-up: adm to hosp 31AUG95 w/3wk hx progressive non prod cough,SOB & fevers;devel abd pain,diarrhea;lost 30lbs;pt had multiple diagnostic studies,devel pleural effusion,viral pneumonia & measles pneumonia;


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