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This is VAERS ID 323614

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 323614 (history)  
Form: Version 1.0  
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 / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF231AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80880 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (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 suggestive of IS. Abd CT (+) for Ileo-colonic IS with severe small bowel dilitation. Barium enema (+) for IS. CBC with Hgb 9.7, Hct 30.1. EEG abnormal but suboptimal.
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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