| VAERS ID: |
25016 (history) |
| Form: |
Version 1.0 |
| Age: |
0.3 |
| Sex: |
Female |
| Location: |
Georgia |
| Vaccinated: | 1986-02-09 |
| Onset: | 1986-02-09 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-07-02 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal,
Grand mal convulsion,
Mental retardation severity unspecified,
Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC Split Type: 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay. |
