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This is VAERS ID 199649

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 199649
VAERS Form:
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (UNKNOWN MFR) / UNKNOWN MFR - / - - / IM
FLU: INFLUENZA (UNKNOWN MFR) / UNKNOWN MFR - / - - / IM
IPV: POLIO VIRUS, INACT. (UNKNOWN MFR) / UNKNOWN MFR - / - - / -
OPV: POLIO VIRUS, ORAL (UNKNOWN MFR) / UNKNOWN MFR - / - - / PO
VARCEL: VARICELLA (UNKNOWN MFR) / UNKNOWN MFR - / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: FEVER, LYMPHADENO, GAIT ABNORM, LAB TEST ABNORM, OSTEOMYELITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of or
CDC 'Split Type':

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated po"lio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history o


Changed on 12/8/2009

VAERS ID: 199649 Before After
VAERS Form:
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (UNKNOWN MFR) DTAP + HIB (NO BRAND NAME) / UNKNOWN MFR UNKNOWN MANUFACTURER - / - - / IM
FLU: INFLUENZA (UNKNOWN MFR) INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MFR UNKNOWN MANUFACTURER - / - - / IM
IPV: POLIO VIRUS, INACT. (UNKNOWN MFR) POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MFR UNKNOWN MANUFACTURER - / - - / -
OPV: POLIO VIRUS, ORAL (UNKNOWN MFR) POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MFR UNKNOWN MANUFACTURER - / - - / PO
VARCEL: VARICELLA (UNKNOWN MFR) VARICELLA (NO BRAND NAME) / UNKNOWN MFR UNKNOWN MANUFACTURER - / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia, FEVER, LYMPHADENO, GAIT ABNORM, LAB TEST ABNORM, OSTEOMYELITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of or
CDC 'Split Type': (blank) PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated po"lio polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history o of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swell


Changed on 7/7/2013

VAERS ID: 199649 Before After
VAERS Form:
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of or
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swell


Changed on 12/14/2016

VAERS ID: 199649 Before After
VAERS Form:
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of or
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swell


Changed on 2/14/2017

VAERS ID: 199649 Before After
VAERS Form:
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of or organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swell swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 9/14/2017

VAERS ID: 199649 Before After
VAERS Form:(blank) 1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 2/14/2018

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 6/14/2018

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 8/14/2018

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 9/14/2018

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 10/14/2018

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 12/24/2020

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 12/30/2020

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 5/7/2021

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.


Changed on 5/21/2021

VAERS ID: 199649 Before After
VAERS Form:1
Age:3.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2003-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Difficulty in walking, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Osteomyelitis, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions: 2 otitis media infections, mild eczema controlled with non-steroidal cream, thigh furuncle, R lower lobe consolidation, MAC, 3mo history L lower leg pain, 3 wk fever up to 38.9C,mycobacterium avium infection.
Allergies:
Diagnostic Lab Data: Chest X-ray- abnormal,purified protein derivative skin test - positive, Bronchoscopy grew acid-fast bacilli, gastric aspirate positive for MC,Radiology findings were absent for bone tumors, leukemia was unlikely since there was a lack of organomegaly and there was a relatively norm 1 complete blood cell count, even though the pt had fever and lytic lesions. The reporters felt that the pt''s presentation with fever, bone pain, leukocytosis, elevated ESR, and lytic bone lesion was concerning for osteomyelitic.
CDC 'Split Type': PJP200300094

Write-up: A report was rec''d concerning a child vaccinated who experienced mycobacterium avium complex (MAC) osteomyelitis an unspecified length of time after receiving influenza vaccine (brand unspecified), DTaP with hepatitis B (brand unspecified), inactivated polio vaccine (brand unspecified), oral polio (brand unspecified), and varicella vaccine (brand unspecified) on an unknown date. No BCG was administered. On an unspecified date the pt presented with a 3 month history of L lower leg pain and a 3 wk history of fevers up to 38.9C. the leg pain was constant dull ache that had increased gradually. Her pain localized over the anterior L lower leg but there was no swelling or erythema. She had a noticeable limp and avoided walking. There was no improvement with non-steroidal anti-inflammatory drugs. The was no history of previous leg pain, trauma, lymph node swelling, rash, insect bite, viral infection or joint swelling. the pt''s mother had a history of recurrent MAC osteomyelitis. The pt was not toxic on physical exam but was anxious and guarded her left leg. Her temp was 38.5C, pulse 120 beats/minute, respiratory rate 28 breaths/minute, and blood pressure 85/45. the exam was remarkable for 1X1cm non tender, soft, mobile, L submandibular lymph node. Her L tibia was tender to palpation without visible edema or erythema. There was no lymphadenopathy or organomegaly. Laboratory date initially revealed a leukocyte count of 17,500 cells/mm3 with 50% lymphocytes, 37 % neutrophils and 1% eosinophils. The haemoglogin was 7.3 g/dl and the platelet count was 583,000 cell/mm3. Erythrocyte sedimentation rate (ESR) and C-reactive protein were elevated at 105 mm/hr and 8.1 mg/dl, respectively. Plain X-rays demonstrated lytic lesions of the tibia and femur. In the opinion of the reporters, the dx was unlikely to have been growing pains as massage and acetaminophen did not help. In addition, growing pains are intermittent, and she had progressive unilateral lower leg pain. Cellulitis was ruled out as there was a lack of localized swelling AND ERYTHEMA OVER THE SYMPTOMATIC AREAS. The pt''s newborn screen was negative for sickle cell disease and titers were no sickle cells on the peripheral blood smear thereby excluding sickle cell disease. The presence of the lutic lesions sad the absence of joint symptoms, make JRA unlikely. There was insufficient information to determine the reporters causality assessment.

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