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This is VAERS ID 61633

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 61633 (history)  
Form: Version 1.0  
Age: 10.0  
Sex: Male  
Location: Maryland  
Vaccinated:1993-11-16
Onset:1993-11-18
   Days after vaccination:2
Submitted: 1994-04-04
   Days after onset:136
Entered: 1994-04-07
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1144W / 2 - / -

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 27NOV93 WBC 6300; Lymphocytes 44%; Granulocytes 56%; UA nl; Ultrasound nl; 30NOV93 urine culture neg;
CDC Split Type: WAES93120809

Write-up: Pt recvd vax 16NOV93 & 18NOV93 exp abdo pain, penile pain, urinary frequency & burning; Pt was seen by MD; UA was WNL; 27NOV93 pt was seen again by MD w/cont pain upon urination which radiated into testicles & pubic bone, cloudy urine;


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