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This is VAERS ID 323614

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 323614 (history)  
Form: Version .0  
Age: 0.4  
Sex: Male  
Location: Louisiana  
Vaccinated:2008-07-17
Onset:2008-07-28
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C80880 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Angiogram, Appendicectomy, Bacteria stool identified, Barium enema abnormal, Chest X-ray normal, Computerised tomogram abnormal, Convulsion, Diarrhoea haemorrhagic, Electroencephalogram abnormal, Enema administration, Full blood count, Gaze palsy, Haematocrit decreased, Haemoglobin decreased, Intussusception, Laparotomy, Lethargy, Lumbar puncture normal, Microcytic anaemia, Nuclear magnetic resonance imaging brain abnormal, Postictal state, Scan brain, Small intestinal intussusception reduction, Somnolence, Tongue disorder, Tremor, Ultrasound abdomen abnormal, Urinary system X-ray, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal lesions, non-neoplastic, non-infectious and non-allergic (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Eosinophilic pneumonia (broad), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None. PMH: none
Allergies:
Diagnostic Lab Data: ultrasound abdomen, contrast study. Labs and Diagnostics: Stool (+) C diff. LP WNL. CT Brain scan with retraction of the L operculum. CXR WNL. MRI/MRA brain (+) for L opercular dilitation. KUB suspicious for bowel obstruction. Abd US
CDC Split Type:

Write-up: Intussusception. 9/12/2008 MR received for DOS 7/28-8/06/2008 with D/C DX: New onset seizures. Intussusception, s/p surgical reduction. Microcytic anemia. Infant presented with new onset of seizures which began the am of admission. Pt''s eyes would roll back with body shaking followed by sleeping. There were 4-5 episodes that am. Vomiting noted after episodes. On admission pt lethargic. PE (+) for scatter L lung wheezes and sleepiness. While being w/u for seizures pt had bloody diarrhea. IS was dx but unable to reduce with BE. Taken to OR for Laparotomy, Reduction of IS, Appendectomy and R femoral central line placement. Pt was kept NPO x 3 days and then po andvanced w/o difficulty. Pt did have 1 seizure during admission. Large tongue noted by neurology.


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