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This is VAERS ID 161756

Case Details

VAERS ID: 161756 (history)  
Form: Version 1.0  
Age: 0.75  
Sex: Male  
Location: Kentucky  
Vaccinated:2000-07-03
Onset:2000-07-19
   Days after vaccination:16
Submitted: 2000-11-05
   Days after onset:109
Entered: 2000-11-10
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 4712149 / 1 LL / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Bacterial infection, Coma, Dyspnoea, Fontanelle bulging, Hypoxia, Mydriasis, Pneumonia, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2000-07-22
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, Motrin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: sepsis work-up, CSF culture showed strep pneumoniae; CSF was sent to CDC where it was sterotyped as #14, which is a sterotyped contained in Prevnar
CDC Split Type:

Write-up: On 7/19, the pt developed a fever and rash on face. On 7/20, the fever continued. On 7/21, the pt developed vomiting and fever. Then later on 7/21, seen at physician''s office with unresponsiveness, forced respirations, bulging fontanelle, dilated left pupil. Pt transferred by ambulance to hospital where pt was intubated. En route to CT, the pt was coded and eventually expired on 7/22.


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