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This is VAERS ID 58232

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

Case Details

VAERS ID: 58232 (history)  
Form: Version .0  
Age: 2.7  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted: 1993-12-10
   Days after onset:1074
Entered: 1993-12-22
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / - - / -

Administered by: Other       Purchased by: Unknown
Symptoms: CARDIOMYOPATHY, DYSPNEA, ECG ABNORM, EFFUS PLEURAL, HEART FAIL
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1991-10-10
   Days after onset: 281
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC Split Type:

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=58232


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