| VAERS ID: |
25341 (history) |
| Form: |
Version 1.0 |
| Age: |
50.0 |
| Sex: |
Female |
| Location: |
Florida |
| Vaccinated: | 1990-04-16 |
| Onset: | 1990-04-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-07-10 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / IM |
Administered by: Private Purchased by: Private
Symptoms: Face oedema,
Headache,
Leukocytosis,
Nausea,
Oedema,
Pain,
Pruritus,
Pyrexia,
Rash,
Tachycardia,
Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Temp 99.2, WBC 19.3, "20 Lymphs, 4 mono, 5 eosinophils, 8 atypical lymphs."
CDC Split Type: EBU900149
Write-up: ABOUT 1 HR P/ VAX, PT EXP H/A, HIVES, PAIN, SWELLING OF TONGUE & OTHER BODY PARTS, & RAPID HEARTBEAT. TX W/ SOLU-MEDROL & BENADRYL. ALSO ER W/NAUSEA, DIFFUSE PRURITUS, ERYTHEMA, TEMP. D/C''D STILL EXP SXS; READM 12OCT90 W/ DELAYED ALLERG RXN |
