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This is VAERS ID 37791

Case Details

VAERS ID: 37791 (history)  
Form: Version 1.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:1991-10-18
Onset:0000-00-00
Submitted: 1991-10-28
Entered: 1991-12-06
   Days after submission:39
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / -

Administered by: Public       Purchased by: Public
Symptoms: Headache, Pleocytosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 4 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness: Sxs of URI;
Preexisting Conditions: Pt has a hx of mild asthma;
Allergies:
Diagnostic Lab Data: CSF-WBC-28total, PMN 52%, Monos 48%, RBC-1, Protein-27, Glucose-75; Meningococcus-?; strep pyogens-neg; group B strep-neg; E. Coli-neg; CSF culture-neg; VDRL-neg;
CDC Split Type: 891310001J

Write-up: 4 days p/receiving flu vax pt was admitted to hosp 22OCT91 w/t100, severe h/a, and an abnormal LP which showed pleocytosis; cerebrospinal fluid culture was neg; pt recovered uneventfully, w/no neurologic sequelae;


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