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This is VAERS ID 39772

Case Details

VAERS ID: 39772 (history)  
Form: Version 1.0  
Age: 49.0  
Sex: Male  
Location: Georgia  
Vaccinated:1992-01-16
Onset:1992-01-26
   Days after vaccination:10
Submitted: 1992-02-25
   Days after onset:30
Entered: 1992-03-03
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. G01031 / UNK UN / SC
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 1F31063 / UNK UN / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 1K31145 / UNK UN / IM
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD. 120602A / UNK MO / PO
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 1L21002 / UNK UN / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, CSF test abnormal, Diplopia, Guillain-Barre syndrome, Headache
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Began Lariam (Mefloquine) on 26JAN92;
Current Illness: NONE
Preexisting Conditions: hx of endocarditis 1986
Allergies:
Diagnostic Lab Data: inc protein on spinal tap;
CDC Split Type:

Write-up: Following vax pt began to exp h/a; woke am of 27JAN92 w/severe h/a & diplopia; Seen by MD then went to hos for MRI, sp tap & lab work; 28JAN92 sx continued began having weakness; pt adm to hosp & given steroid therapy; cont to have diplopia


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