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This is VAERS ID 440919

Case Details

VAERS ID: 440919 (history)  
Form: Version 1.0  
Age: 1.01  
Sex: Female  
Location: California  
Vaccinated:2011-10-10
Onset:2011-10-20
   Days after vaccination:10
Submitted: 2011-10-25
   Days after onset:5
Entered: 2011-11-01
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / UNK RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / UNK RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 1 RL / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Brain oedema, CSF test, Diarrhoea, Endotracheal intubation, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Viral test, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC Split Type:

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


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