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This is VAERS ID 326440

(NOTE: This result is from the 6/14/2018 version of the VAERS database)

Case Details

VAERS ID: 326440 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Florida  
Vaccinated:2008-06-03
Onset:2008-07-08
   Days after vaccination:35
Submitted: 2008-09-29
   Days after onset:83
Entered: 2008-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B141AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF349AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45887 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1830U / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal distension, Diarrhoea, Intussusception, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: REFLUX, BUT OFF MEDS AND DOING WELL
Allergies:
Diagnostic Lab Data: LABS: air enema (+) for IS but could not reduce.
CDC Split Type:

Write-up: INFANT DEVELOPED VOMITING, DIARRHEA, AND ABDOMINAL DISTENTION 1 MONTH AND 1 WEEK POST VACCINE ADMINISTRATION, AND WAS DIAGNOSED WITH INTRASUCCEPTION REQUIRING EMERGENCY SURGERY. 10/3/08 Reviewed hospital D/C summary of 7/11-7/17/2008. FINAL DX: Intussusception, exp lap w/small bowel resection & primary anastomosis Records reveal patient experienced fever & persistent emesis x 3-4 days, constipation, lethargy, abdominal distended & taut, dark red stool. Findings in OR included small segment of necrotic bowel which was resected. Admitted PICU, PICC line placed & started on parenteral nutrition. Gradually returned to normal BMs & diet advanced fo full formula. D/C to home w/surgery clinic f/u. 10/17/08 Reviewed additional hospital records of 7/11-7/17/2008. Included path report which reveals necrotizing entercolitis.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=326440


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