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Life Threatening? No
Write-up: Information regarding PREVNAR was received from a physician regarding a female patient who received the fourth dose on 05-May-2008 at 12 months of age and experienced neurogenic septic shock, neurogenic respiratory failure, brain dead, pneumococcal bacteria in blood, vaccine failure and pneumococcal meningitis at 13 months of age. On 11-May-2008, the patient was admitted to the intensive care unit brain dead and in neurogenic respiratory failure. Laboratory results revealed pneumococcal bacteria in blood and a large amount of pneumococcal bacteria that grew in less than eight hours in CSF culture, which led to the additional diagnosis of pneumococcal meningitis. Serotype testing was not performed. An antimicrobial susceptibility test was unremarkable. The physician felt "like this is a vaccine failure". The patient also developed neurogenic septic shock. Treatment included ROCEPHIN and VANCOMYCIN. On 12-May-2008, the patient died. The cause of death were reported as meningitis pneumococcal, respiratory failure, septic shock, vaccination failure, brain death and pneumococcal sepsis. No additional information was available at the time of this report. 6/3/08-records received for DOS 5/11-5/13/08-Date of Death 5/13/08. Final DX: Meningitis secondary to Streptococcus pneumoniae. Gram-positive coccal bacteremia. Admission neurologic examination consistent with brain death, subsequently confirmed. Brain death confirmed by repeat examination and confirmatory tests through course of hospitalization. Admitted via emergency room previously well child until 3/10/08, warm to touch temperature 101, listless and febrile with temperature as high as 104.4. Vomited. Became limp, feet cold, apneic. CPR initiated at home. Cyanotic. Pupils dilated and nonreactive. GCS 3. Heart rate 170 but not palpable pulses. No spontaneous respirations. Intubation, mechanical ventilation.
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