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This is VAERS ID 152566

Case Details

VAERS ID: 152566 (history)  
Form: Version 1.0  
Age: 27.0  
Sex: Male  
Location: California  
   Days after vaccination:13
Submitted: 2000-05-24
   Days after onset:42
Entered: 2000-06-01
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Face oedema, Hypoxia, Lymphoma, Mouth ulceration, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Malignant lymphomas (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Haematological malignant tumours (narrow), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2000-05-25
   Days after onset: 43
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00052019

Write-up: On 4/12/00, the pt developed facial swelling on the right followed by a rash which spread over the face, neck, chest, back, and some areas of the arms and legs. The reporter noted that the pt had a fever of 104-105 but he did not have lesions in his mouth. The reporter indicated that the pt received therapy with cephalexin for treatment of the swollen cheek after the vax. At the time of the report, 5/18/00, the reporter indicated that the pt was intubated and hospitalized in an ICU. The reporter indicated that the events were life threatening. Follow-up information dated 9/26/00 stated that a bone marrow biopsy showed Natural Killer Cell Lymphoma. The pt died in the hospital on 5/25/00 after a 10 day admission. It was noted that the final cause of death was Natural Killer Cell Lymphoma.

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