VAERS ID: |
25485 (history) |
Form: |
Version .0 |
Age: |
1.3 |
Sex: |
Male |
Location: |
New York |
Vaccinated: | 1990-02-26 |
Onset: | 1990-03-10 |
Days after vaccination: | 12 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
409672130R / - |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Hepatic function abnormal,
Pyrexia,
Rash maculo-papular,
Vasculitis SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vasculitis (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: no relevant hx Allergies: Diagnostic Lab Data: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM CDC Split Type: WAES90031176
Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis |