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This is VAERS ID 93590

Case Details

VAERS ID: 93590 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Female  
Location: Foreign  
Vaccinated:1995-02-23
Onset:1995-03-03
   Days after vaccination:8
Submitted: 1997-01-03
   Days after onset:672
Entered: 1997-01-07
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia
SMQs:, Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-09-04
   Days after onset: 550
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


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