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This is VAERS ID 57353

Case Details

VAERS ID: 57353 (history)  
Form: Version 1.0  
Age: 78.0  
Sex: Male  
Location: California  
Vaccinated:1993-10-22
Onset:1993-10-25
   Days after vaccination:3
Submitted: 1993-11-08
   Days after onset:14
Entered: 1993-11-15
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Back pain, CSF test abnormal, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Noninfectious diarrhoea (broad), Immune-mediated/autoimmune disorders (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: NS~ ()~~~In patient
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC Split Type: 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


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