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This is VAERS ID 27304

Case Details

VAERS ID: 27304 (history)  
Form: Version 1.0  
Age: 82.0  
Sex: Female  
Location: Florida  
Vaccinated:1990-10-30
Onset:1990-11-09
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Brain stem syndrome, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC Split Type: 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


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