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This is VAERS ID 49045

Case Details

VAERS ID: 49045 (history)  
Form: Version 1.0  
Age: 69.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1992-11-06
Onset:1992-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC Split Type:

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


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