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This is VAERS ID 119781

Case Details

VAERS ID: 119781 (history)  
Form: Version 1.0  
Age: 22.0  
Sex: Male  
Location: Georgia  
   Days after vaccination:0
Submitted: 1999-03-01
   Days after onset:160
Entered: 1999-03-08
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Military       Purchased by: Unknown
Symptoms: Affect lability, Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Diagnostic Lab Data:
CDC Split Type:

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.

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