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This is VAERS ID 483022

Case Details

VAERS ID: 483022 (history)  
Form: Version 1.0  
Age: 87.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2010-01-15
Onset:2010-01-18
   Days after vaccination:3
Submitted: 2013-01-30
   Days after onset:1108
Entered: 2013-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 6 AR / SYR
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 AR / SYR

Administered by: Public       Purchased by: Public
Symptoms: Blood glucose increased, Blood test, Chills, Confusional state, Encephalitis viral, General physical health deterioration, Lumbar puncture abnormal, Mental status changes, Neck pain, Pyrexia, Urinary tract infection
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2011-05-17
   Days after onset: 483
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin, fluid pill, vitamin D, eye drops for Glaucoma.
Current Illness: None
Preexisting Conditions: Diabetes, Leaking heart valve
Allergies:
Diagnostic Lab Data: Blood work & lumbar puncture.
CDC Split Type:

Write-up: Extreme neck pain, increase blood sugar & confusion. Fever & chills began two days later. Took to doctor''s office on 01/25/2010 & was referred to ER where she was diagnosed with UTI & sent home with oral antibiotics. Health continued to deteriorate so had her taken by ambulance to ER where she wad admitted due to deminished mental capacity. Diagnosed with Viral Encaphlitis. A lumbar puncture done on 02/03/2010 to confirm diagnoses. IV anitibiotic was administered for 21 days. On 02/08/2010 was transferred to nursing home for completement of IV. Never regained health.


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