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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC.||- / UNK||- / -|
Administered by: Unknown Purchased by: ??
Symptoms: Abdominal distension, Abdominal pain, Acute respiratory failure, Adenocarcinoma of colon, Anaemia, Arrhythmia, Atrial fibrillation, Blood bicarbonate increased, Blood lactate dehydrogenase increased, Blood pH normal, Cardiac failure, Chest X-ray abnormal, Chronic lymphocytic leukaemia, Coma, Constipation, Cough, Death, Depressed level of consciousness, Dyspnoea, Hepatosplenomegaly, Hyperglycaemia, Hypotension, Hypoxia, Intensive care, Leukocytosis, Lung infiltration, Lymphocyte count increased, Lymphocytosis, Oxygen saturation decreased, PCO2 increased, Platelet count decreased, Pleural effusion, Pneumonia, Productive cough, Pulmonary embolism, Purpura, Purulent discharge, Pyrexia, Renal failure, Respiratory distress, Respiratory failure, Sedation, Sepsis, Septic shock, Thrombocytopenia, Vomiting, White blood cell count increased, Ejection fraction decreased, Polymerase chain reaction, Hypophonesis, Sputum culture positive, Gastrointestinal hypomotility, Brain natriuretic peptide increased, Computerised tomogram thorax abnormal, Echocardiogram abnormal, Colectomy, Respiratory tract infection, Bronchoalveolar lavage abnormal, Endotracheal intubation, Acinetobacter test positive, Bordetella test positive, Enterococcus test positive, Streptococcus test positive, Candida test positive, Influenza virus test negative, Multiple organ dysfunction syndrome, Procalcitonin normal, Fungal disease carrier
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:
Write-up: Acute community acquired pneumonia; Bilateral pulmonary thromboembolism; death; failure of several organs (heart, kidney)/ Multiorgan failure; desaturation, bronchospasm/ worsening of the ARI/ serious ARI; Acute abdomen; Coma; Hypergycemia; Complete arrythmia by paroxysmal artrial fibrilation; Sepsis: septic shock; Ascending colon adenocarcinoma (T3N2M0); Chronic lymphocytic leukemia (stage All); This spontaneous report as received from a physician refers to a 73-year-old male patient. The patient''s concurrent conditions included type 2 diabetes mellitus on treatment, not complicated, moderate chronic obstructive pulmonary disease (COPD) type chronic bronchitis, basal dyspnea II-III/IV (no previous hospital admissions due to pneumonia nor acute respiratory insufficiency (ARI), nor oxygen-therapy at home), chronic ischemic cardiopathy (she had effort angina in June 1996, but was asymptomatic since then). The patient was ex-smoker and had no recent international travels and no pets. Historical medications included anti-flu vaccination. On an unknown date (reported as more than 5 years ago), the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX 23) (dose, frequency, route of administration, lot #, expiration date were not provided) for prophylaxis. On unspecified date, in 1997, he was diagnosed with chronic lymphatic leukemia (stage All, at the beginning) with hepatosplenomegaly. It was treated with Chlorambucil since 2002 (leukocytes were higher than 90.000 on an unknown date). On an unknown date, the patient experienced ascending colon adenocarcinoma (T3N2M0). On unspecified date in October 2009, he underwent right hemilectomy (resection ends free of tumoral lesion). On unspecified date, in March 2011, underwent eventration repair with an abdominal net. On unspecified date, after the surgery, the patient experienced bilateral pulmonary thromboembolism. On 01-JAN-2012, the patient was admitted to hospital with acute community-acquired pneumonia (he had cough, fever, sputum, and dyspnea increased). On respiratory auscultation there was noisy breathing, bilateral basal hypophonesis, mostly on the left side. He had partial respiratory insufficiency, on thorax radiography there was right basal alveolar infiltrate and mild left pleural effusion. Urine anti-pneumococcal antigen was positive, nasopharyngeal smear flu test were negative. Antibiotic treatment was started with amoxicillin (+) clavulanic acid. Blood culture was positive for Streptococcus pneumoniae. On 04-JAN-2012, the patient experienced early complications (controlled): hyperglycemia (insulinization) and complete arrythmia by paroxysmal atrial fibrillation. On 24-JAN-2012, the oxygen-therapy was still needed. On 25-JAN-2012, the patient experienced desaturation and bronchospasm. Sputum culture showed Bordetella bronchiseptica. Treatment with levofloxacin was started. On 31-JAN-2012, the patient experienced abdominal complications of vomiting, constipation for 3 days, abdominal distention, painful at diffuse palpation, without peritonism, decreased peristalsis, no bigger masses or megalies, fast atrial fibrillation, fever, worsening of the ARI. The patient was moved to the intensive care unit (ICU) due to serious ARI, abdominal distension, hypoxemia (Oxygen saturation: 75%) and decrease of the consciousness level (coma). Arterial Blood Gas (ABG) results were as follows: pH 7.44, pCO2: 61.7 mmHg, Bicarbonate: 40.7 mmol/L. The patient was sedated, endotracheal intubation was performed: purulent secretions were observed. Additional tests included: Abdominal Rx: big gastric distension with air pattern in small bowel and colon with normal characteristics, abundant fecal remains; Thorax computed axial tomography (CAT): mostly alveolar pattern in right upper lobe (probably related to the bronchoaspiration). Atelectasis in posterior segments ofthe inferior lobes. No pulmonary nodes; Abdominal CAT: No signs of intestinal obstruction; two cystic images in hepatic parenchyma. The patient''s leukocytosis (lymphocytosis) was increasing, lactate dehydrogenase was increasing. Polymerase Chain Reaction (PCR): 55 (unit not provided), procalcitonin: 0.79 (unit not provided), Pro-B-type natriuretic peptide (BNP): 8700 (unit not provided). The patient experienced important hemodynamic worsening: sepsis: septic shock. On 01-FEB-2012, the patient experienced respiratory insufficiency which evolved to respiratory distress (orotracheal intubation was performed). On 01-FEB-2012, he experienced additional dysfunction and failure of several organs (heart, kidney), fever (higher than 38 degrees Celsius), hypotension: noradrenalin was given. Bronchial Alveolar Lavage (BAL) and BAS (more than 10^4): Acinetobacter baumannii, Candida tropicalis (colinization): treatment with Colistin and T?gecycline (high doses), and Voriconazole was started. Blood culture wa s positive for Enterococcus faecium and treatment with Daptomycin was started. Echocardiogram showed contractility alteration, ejection fraction decrease, no vegetations. There were increased pulmonary infiltrates and respiratory secretions. Reticulated ecchymotic purpura in the middle and lateral of the abdomen was observed. lncreased leukocytosis (due to the lymphocytes), with anemia (haemoglobin of 9.2 (unit not provided)) and thrombocytopenia (platelets 57.000 (unit not provided)); IQ alterations and aPTT were observed. On 04-FEB-2012, BAL showed Acinetobacter baumannii and filamentous fungi. On 08-FEB-2012, the patient experienced multiorgan failure. On 12-FEB-2012, the patient died. The cause of death was not reported. It was not reported if the autopsy was performed. The outcome of all events at the time of the patient''s death was unknown. The causality assessment was not provided. Upon internal review the events of acute community acquired pneumonia, ascending colon adenocarcinoma, chronic lymphocytic leukemia, bilateral pulmonary thromboembolism, artrial fibrillation, acute abdomen, coma, multiorgan failure, acute respiratory failure and sepsis were determined to be medically significant. This is one of two reports regarding the same patient.; Sender''s Comments: ES-009507513-1910ESP015155:
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