| VAERS ID: |
106323 (history) |
| Form: |
Version 1.0 |
| Age: |
44.0 |
| Sex: |
Male |
| Location: |
Ohio |
| Vaccinated: | 1997-11-02 |
| Onset: | 1997-11-06 |
| Days after vaccination: | 4 |
| Submitted: |
1998-01-07 |
| Days after onset: | 62 |
| Entered: |
1998-01-13 |
| Days after submission: | 6 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Other Purchased by: Other
Symptoms: Asthenia,
Guillain-Barre syndrome,
Hypoxia,
Paralysis
SMQs:, Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Respiratory failure (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? Yes
Birth Defect? No
Died? Yes
Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dilantin, decadron 9started in JUL post op brain surg)
Current Illness: glioblastoma
Preexisting Conditions: before dx glioblasma, excellent health before & ater;
Allergies:
Diagnostic Lab Data: several CT scans, MRI, blood work, etc;refused to test for GBS;
CDC Split Type:
Write-up: quadriplegia & 100% vent assisted;pt too weakened to cont w/chemotherapy;prognosis is less than 2mo; |
