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This is VAERS ID 58132

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 58132 (history)  
Form: Version .0  
Age: 73.6  
Sex: Male  
Location: Virginia  
Vaccinated:1993-10-08
Onset:1993-10-28
   Days after vaccination:20
Submitted: 1993-11-16
   Days after onset:19
Entered: 1993-12-14
   Days after submission:28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 / WYETH 4938167 / 1 - / IM

Administered by: Other       Purchased by: Unknown
Symptoms: ASTHENIA, CSF ABNORM, DYSARTHRIA, GUILLAIN BARRE SYND, MYASTHENIA
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: VINCRISTINE, HYTRIN, HYDROCHLOROTHIAZIDE, PRILOSEC, MICRONASE, NORVASC, ISOSORBIDE DINITRATE, CYTOXAN, NOVANTRONE, NITROGLYCERIN OINTMENT;
Current Illness: Large cell lymphoma of abdomen;
Preexisting Conditions: Severe atherosclerotic cardiovascular disease, s/p coronary artery bypass graft, MIs, & large cell lymphoma of abdomen; non-insulin dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CSF protein 155;
CDC Split Type:

Write-up: Dx in SEP93 w/large cell lymphoma of abdomen; recvd 3 courses of chemotherapy; 08OCT93 recvd vax; 28OCT93 exp weakness & skeletal pain; fell several times; admitted to hosp 29OCT93, dx of rule out GBS;


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