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This is VAERS ID 323866

(NOTE: This result is from the 3/2/2010 version of the VAERS database)

Case Details

VAERS ID: 323866 (history)  
Form: Version .0  
Age: 0.5  
Sex: Male  
Location: New Jersey  
Vaccinated:2008-08-05
Onset:2008-08-22
   Days after vaccination:17
Submitted: 2008-08-26
   Days after onset:4
Entered: 2008-09-02
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 2 UN / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1203R / 2 UN / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0342 / 2 UN / IM
PNC: PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC C86145 / 2 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1886U / 2 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Abdominal X-ray, Barium enema abnormal, Enema administration, Full blood count, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Hypophagia, Intussusception, Laboratory test abnormal, Mucous stools, Platelet count decreased, Pyrexia, Red blood cell count decreased, Ultrasound abdomen abnormal, White blood cell count normal
SMQs:, Haematopoietic erythropenia (narrow), Haematopoietic thrombocytopenia (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), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Ischaemic colitis (broad)

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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: 7/3/08 - Bronchitis. PMH: none
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnsotics: Abd US (+) for evidence for IS. Abd X-ray suggestive of possible ileus. CBC with WBC 7.7, RBC 2.0-4.28, Hgb 5.5-11, Hct 16.1-33.3, platelets 65K-389K. Repeat specimen 3 hrs later all WNL. Chemistry abnorma
CDC Split Type:

Write-up: Baby to see pediatrician for bloody stools x 2 and fever 8-22-08. Dx hematochezia, R/O intussusception. Admitted to hospital and dx''d with positive intussusception on 8/22/08. 9/10/2008 ER rec received from CDC for DOS 8/22/08 with D/C DX: Intussusception. Infant presented with fever, decreased po intake and bloody/mucousy stool. Frank blood in diaper at PCP office. To ER to r/o IS. Barium enema used to confirm and reduce IS of the large bowel in the RLQ.


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