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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)

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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