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This is VAERS ID 58371

Case Details

VAERS ID: 58371 (history)  
Form: Version 1.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted: 1993-12-15
   Days after onset:41
Entered: 1993-12-22
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Angiopathy, Blindness, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC Split Type:

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


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