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From the 8/31/2010 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 293388

Case Details

VAERS ID: 293388 (history)  
Form: Version .0  
Age: 18.0  
Sex: Female  
Location: New York  
   Days after vaccination:115
Submitted: 2007-10-12
   Days after onset:6
Entered: 2007-10-17
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Back pain, Blood creatinine increased, Blood culture negative, Brain death, Brain herniation, Brain oedema, Bronchoscopy, C-reactive protein increased, CSF culture positive, CSF glucose decreased, CSF neutrophil count increased, CSF pressure increased, CSF protein increased, CSF white blood cell count increased, Chest X-ray normal, Chills, Computerised tomogram abnormal, Culture urine negative, Death, Echocardiogram normal, Encephalitis, Headache, Intubation, Lumbar puncture, Lymphocyte count decreased, Malaise, Meningitis meningococcal, Mydriasis, Nausea, Neck pain, Neutrophil count increased, Pallor, Photophobia, Posturing, Pupil fixed, Pyrexia, Red blood cells CSF positive, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-10-08
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical history and concomitant medications not reported; it was unknown if the patient was ill at time of vaccination.
Diagnostic Lab Data: 07/Oct/2007: Brain CT showed meningococcal disease ER LABS: CT scan & CXR WNL. WBC 14.9 (H), Neutros 87.2 (H), lymphs 6.4 (L). Creatinine 1.2 (H), ALT 27 (L). CSF WBC 4455 (H), RBC 171 (H), neutros 100% (H), glucose 29 (L), protein 371
CDC Split Type: 200703414

Write-up: This case was received from a health care professional on 10 October 2007. Additional information was received from a newspaper article. An 18-year-old female patient received a meningococcal vaccine (name, manufacturer, and lot number not reported) on an unspecified date. The patient, who was a college freshman, travelled on 05 October 2007 to visit her family for the weekend. She reportedly felt "slightly ill" upon her arrival, and subsequently took an aspirin and went to bed, awakening at 1:30pm the following afternoon ''appearing refreshed". She became feverish again that night, and awoke at 1:00am the morning of 07 October 2007 with chills and a severe headache, complaining that "my head is about to explode". She was taken to a local hospital, where a CAT scan of the brain revealed meningococcal disease in her brain and brain stem. She was immediately transferred to another hospital, and died that evening of 07 October 2007 due to complications of meningitis. The health department noted that "lab tests have not yet confirmed the strain of meningitis" but that it was "likely the type not prevented by the vaccination". Past medical history and concomitant medications were unknown: it was not known if the patient was ill at the time of vaccination. 10/18/07 Patient name received from FDA. 10/18/07 Received death certificate from funeral home which states COD as brain death due to cerebral herniation and meningoencephalitis. 10/26/07 Received vax record from pcp which indicates patient received HPV & Menactra on 5/10/2007. VAERS database updated w/same. Vax record indicates patient also received 2nd dose of HPV 6/13/2007, Lot # 0523U, left arm. 11/27/07 Reviewed hospital medical records which reveal patient experienced HA, fever & neck pain x 1 day. Had come home from college 10/5 & developed chills next day. Seen in outlying ER where LP showed high pressure, grossly purulent CSF growing meningococcus. Intubated & IV antibiotics started & transferred to higher level of care. Neurosurgery & ID consults don

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