chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 11.0
Sex: M
Vaccine: HEPA, MNQ, TDAP, VARCEL
Symptoms: Injection site erythema, Oedema peripheral
Clinical narrative: Patient was taken to ER approximately 6:00 12/5/07.  Had swollen arm with red area.  States swelling has gone down a lot.  Right arm circumference 12/6/07, arm 9" 25 mm red area at varicella site.  Instructed use of cold compresses 10 minutes on 10 minutes off several times a day.  Take Tylenol for age, weight.
Age: 0.5
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC, RV5
Symptoms: Haematochezia
Clinical narrative: Information has been received from a nurse practitioner concerning a 6 month old male patient who on an unspecified date was vaccinated orally with a third dose of ROTATEQ "on a Friday."  Concomitant vaccinations on the same day included PEDVAX HIB (OMPC) (manufacturer unknown), DTaP (manufacturer unknown), IPV (unspecified) (manufacturer unknown) and PREVNAR.  Subsequently, "by the next Monday" the patient had a bloody stool.  Medical attention was sought in the office.  It was unspecified if lab studies were performed.  At the time of the report, the patient's status was unknown.  There was no product quality complaint involved.  Upon internal review "a bloody stool" was considered to be an other important medical event.  Additional information has been requested.
Age: 13.0
Sex: F
Vaccine: HPV4
Symptoms: Abdominal pain lower, Thrombosis
Clinical narrative: Information has been received from a female concerning her 13 year old granddaughter with no pertinent medical history and no history of drug reactions or allergies who on unspecified dates was vaccinated with the complete series of GARDASIL.  There was no concomitant medication.  Subsequently, in April 2008, the patient experienced severe pain on the bottom of her stomach on both sides and she was having blood clots.  Because of these symptoms, the patient was hospitalized for 4 days.  The patient also developed cyst.  Ultrasound was performed (results not reported).  As of 16-JUL-2008, the patient was at home but still complaining about severe pain in the lower part of her stomach and still has blood clots.  This is one of three reports from the same source.  (WAES: 0807USA03551 and 0807USA03552).  Additional information has been requested. 8/21/08-ER records for DOS 4/2-4/4/08-presented with C/O abdominal pain and cramping. Menses began 3-4 days prior. Pale diaphoretic.  Impression:abdominal pain, syncope. Temperature elevated. Urine culture E. coli. Seen in OB/GYN office 4/8/08-C/O continuous bleeding and abdominal pain. Follicular cyst of ovary. 6/4/08-continues to have heavy bleeding with cramps.Prescribed Ortho Nuvum 1/35. Seen on 7/15/08-last period without problems no longer taking birth control pills. Office did not administer Gadasil to client.
Age: 16.0
Sex: F
Vaccine: HEPA, HPV4
Symptoms: Convulsion, Fall, Musculoskeletal stiffness, No reaction on previous exposure to drug, Tremor
Clinical narrative: Information has been received from a nurse concerning a 16 year old female who on unspecified dates was vaccinated with the first and second doses of GARDASIL.  The first and second doses did not cause symptoms.  On 16-JUL-2008 the patient was vaccinated with the third dose of GARDASIL.  Concomitant therapy included VAQTA (manufacturer unknown).  The patient experienced "seizure-like symptoms within 30 seconds of her third dose".  The symptoms were falling on a table, mild shaking including her legs, hand stiffening and urinating on herself.  On an unspecified date the patient was recovered.  The patient saw the doctor and sought unspecified medical attention.  Upon internal review seizure-like symptoms were considered to be other important medical event.  Additional information has been requested.
Age: 16.0
Sex: F
Vaccine: HEPA, HPV4
Symptoms: Urinary incontinence
Clinical narrative: Information has been received from a nurse concerning a 16 year old female who on unspecified dates was vaccinated with the first and second doses of GARDASIL.  The first and second doses did not cause symptoms.  On 16-JUL-2008 the patient was vaccinated with the third dose of GARDASIL.  Concomitant therapy included VAQTA (manufacturer unknown).  The patient experienced "seizure-like symptoms within 30 seconds of her third dose".  The symptoms were falling on a table, mild shaking including her legs, hand stiffening and urinating on herself.  On an unspecified date the patient was recovered.  The patient saw the doctor and sought unspecified medical attention.  Upon internal review seizure-like symptoms were considered to be other important medical event.  Additional information has been requested.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Erythema, Induration
Clinical narrative: Received MMR, DTaP, Varicella, IPV 2d later red 2x2 area with induration (R) upper arm and 1x1" erythema area with 1/4" dia induration below
Age: 1.3
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Pyrexia
Clinical narrative: High fevers within 2 days of MMR, Varicella, lasted 3 days.
Age: 7.0
Sex: F
Vaccine: HEPA, PNC, VARCEL
Symptoms: Erythema, Oedema peripheral
Clinical narrative: Admin VZV LLT SQ, got red/swollen
Age: 11.0
Sex: F
Vaccine: HPV4
Symptoms: Meningitis viral
Clinical narrative: Information has been received from a nurse concerning an 11 or 12 year old daughter of a co-worker who was vaccinated with the first dose of GARDASIL.  The patient, was diagnosed of "viral meningitis" after receiving the first dose and was hospitalized for a few days.  The nurse reported that the patient was home as of 10-JUL-2008, but she still had left over symptoms.  The patient had not recovered.  No further information is available.
Age: 27.0
Sex: F
Vaccine: HPV4
Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Inappropriate schedule of drug administration
Clinical narrative: Information has been received from a physician through the Merck pregnancy registry for GARDASIL concerning a 27 year old female who on 29-MAY-2008, was vaccinated with the first dose of GARDASIL, 0.5ml, IM and is now pregnant.  On 08-MAY-2008, the patient had her last menstrual period (LMP) (estimated date of delivery 12-FEB-2009).  On 14-JUL-2008, the patient was experiencing a miscarriage.  The patient sought medical attention at the physician's office.  On 14-JUL-2008, the patient was scheduled for a Dilation and Curettage (D&C) procedure.  At the time of reporting, the outcome was unknown.  Upon internal review, miscarriage was considered to be an other important medical event.  Additional information has been requested.
Age: 21.0
Sex: F
Vaccine: HPV4
Symptoms: Abortion induced, Drug exposure during pregnancy, Pregnancy test positive
Clinical narrative: Initial and follow-up information has been received from a registered nurse for the Pregnancy Registry of GARDASIL concerning a 21 year old female with no pertinent medical history or drug reactions or allergies who on 21-FEB-2007 was vaccinated with GARDASIL, lot# 653736/0014U (first dose). Concomitant therapy included YASMIN. As of 02-APR-2007 the patient was pregnant (LMP = 28-FEB-2007, estimated delivery date = 05-DEC-2007). There were no adverse experiences related to this event. The patient sought unspecified medical attention (not further specified). Follow-up information indicated that the patient terminated the pregnancy at less than 12 weeks. Upon internal review the elective termination was considered to be an other important medical event. Additional information is not expected.
Age: 6.0
Sex: M
Vaccine: HEP, VARCEL
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: 1 day after Varivax, developed 5 x 6cm redness, induration on left thigh, vaccine site.  Ice pack, Benadryl.
Age: 65.0
Sex: F
Vaccine: PPV
Symptoms: Cellulitis, Erythema, Oedema peripheral, White blood cell count increased
Clinical narrative: 7/19/08 ER visit for red swollen arm.  Dx with cellulitis and admitted to hospital for abx therapy.  8/11/2008 MR received for DOS 7/19-22/2008 with D/C DX: Cellulitis most likely possible immune reaction to Pneumovax. Pt presented to ER following a syncopal episode with fever, chills and injection site pain, erythema, induration. Pt had felt nauseous and gone to sink to vomit but passed out onto the floor where pt was found. In ER pt had fever of 102.6'F, exam WNL except for injection site cellutis.  Admitted for abx, IVF and telemetry with good resolution of sx.
Age: 65.0
Sex: M
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: 7/19/08 went to ER for erythema and tenderness at injection site. Received KEFLEX sent home.
Age: 42.0
Sex: M
Vaccine: VARCEL
Symptoms: Rash vesicular, Vaccination failure
Clinical narrative: 1. Varicella type Rash - Extensive
Age: 14.0
Sex: M
Vaccine: HEPA, MEN, TD
Symptoms: Blister, Pyrexia, Rash papular
Clinical narrative: Patient seen at urgent care - fever 99, rash - scattered red papules, slightly elevated/blisters in center - 7/16/08.
Age: 14.0
Sex: F
Vaccine: HEPA, MNQ, TDAP
Symptoms: Loss of consciousness, Pallor, Paraesthesia, Syncope
Clinical narrative: Vaccines Tdap, MENACTRA, HEP A administered at 11:00 am, 5 min prior to reaction. Symptoms include syncope with LOC <5 seconds, pale, hands/feet tingling. Pt with noted (+) mensus, increased anxiety, increased hunger prior to shots vs as follows- BP-110/76, O2 98%, RA, pulse 68, Resp 20. Pt asked to lie supine with legs elevated, gave sugar beverage. MD at BS.
Age: 62.0
Sex: M
Vaccine: VARZOS, VARZOS
Symptoms: Herpes zoster, Pain, Rash, Skin test
Clinical narrative: 62 y/o white male with shingles like skin eruption some 4-5 days after the receipt of ZOSTAVAX.  Rash, focal, pain.
Age: 62.0
Sex: M
Vaccine: VARZOS, VARZOS
Symptoms: Arthralgia, Herpes zoster, Pain in extremity
Clinical narrative: 62 y/o white male with shingles like skin eruption some 4-5 days after the receipt of ZOSTAVAX.  Rash, focal, pain.
Age: 11.0
Sex: F
Vaccine: HPV4, TDAP, VARCEL
Symptoms: Decreased appetite, Erythema, Somnolence
Clinical narrative: Approximately 6 x 18 cm area of mild erythema underside of upper arm where given, decreased appetite, somnolence.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Headache, Herpes zoster
Clinical narrative: Pt rec'd ZOSTAVAX July 15 and on July 16 had headache. Then developed zoster on (L) left side of face
Age: 0.2
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Pyrexia
Clinical narrative: Fever 104.
Age: 19.0
Sex: M
Vaccine: SMALL
Symptoms: Eye disorder, Eyelid oedema, Ocular hyperaemia
Clinical narrative: SM noted that he could feel a "bump" on this inside of his L eyelid. The next day it was more swollen and he reported to sick call at his PC clinic. They were uncertain of what it was. On 7/18 he returned to the research nurse for his follow up visit for the SPV study and her concern was that this was autoinoculation to the eye. Symptoms: Swelling, Red eyes.
Age: 38.0
Sex: M
Vaccine: HEPAB, SMALL
Symptoms: Arthralgia, Basophil count normal, Basophil percentage, Dyspnoea, Eosinophil count normal
Clinical narrative: SM developed raised, red, itchy lesion on arms, neck, upper legs. A few days later, he noted fatigue and malaise, one episode of SOB on 7/7/08 as well as arthralgias.
Age: 38.0
Sex: M
Vaccine: HEPAB, SMALL
Symptoms: Eosinophil percentage, Erythema, Fatigue, Haematocrit normal, Haemoglobin normal
Clinical narrative: SM developed raised, red, itchy lesion on arms, neck, upper legs. A few days later, he noted fatigue and malaise, one episode of SOB on 7/7/08 as well as arthralgias.
Age: 38.0
Sex: M
Vaccine: HEPAB, SMALL
Symptoms: Lymphocyte count normal, Lymphocyte percentage, Malaise, Mean cell haemoglobin concentration, Mean cell haemoglobin normal
Clinical narrative: SM developed raised, red, itchy lesion on arms, neck, upper legs. A few days later, he noted fatigue and malaise, one episode of SOB on 7/7/08 as well as arthralgias.
Age: 38.0
Sex: M
Vaccine: HEPAB, SMALL
Symptoms: Mean cell volume, Mean platelet volume normal, Monocyte count normal, Monocyte percentage, Neutrophil count normal
Clinical narrative: SM developed raised, red, itchy lesion on arms, neck, upper legs. A few days later, he noted fatigue and malaise, one episode of SOB on 7/7/08 as well as arthralgias.
Age: 38.0
Sex: M
Vaccine: HEPAB, SMALL
Symptoms: Neutrophil percentage, Platelet count normal, Pruritus, Pyrexia, Rash pruritic
Clinical narrative: SM developed raised, red, itchy lesion on arms, neck, upper legs. A few days later, he noted fatigue and malaise, one episode of SOB on 7/7/08 as well as arthralgias.
Age: 38.0
Sex: M
Vaccine: HEPAB, SMALL
Symptoms: Red blood cell count normal, Red blood cell sedimentation rate increased, Rheumatoid factor increased, Skin lesion, White blood cell count normal
Clinical narrative: SM developed raised, red, itchy lesion on arms, neck, upper legs. A few days later, he noted fatigue and malaise, one episode of SOB on 7/7/08 as well as arthralgias.
Age: 38.0
Sex: M
Vaccine: HEPAB, SMALL
Symptoms: X-ray limb normal
Clinical narrative: SM developed raised, red, itchy lesion on arms, neck, upper legs. A few days later, he noted fatigue and malaise, one episode of SOB on 7/7/08 as well as arthralgias.
Age: 14.0
Sex: M
Vaccine: HEPA, MNQ, TDAP, VARCEL
Symptoms: Loss of consciousness, Syncope
Clinical narrative: After administering 4 vaccines, patient fainted lasting approximately 5 sec - 108 C of LOC.  Layed patient down and he woke up and felt ok.  Had patient lay on table, gave pretzels and juice.  VSS.  Patient discharged with mom feeling fine.  Ambulated well.
Age: 4.0
Sex: M
Vaccine: DTAP, HEPA, VARCEL
Symptoms: Erythema, Induration
Clinical narrative: Within 24 hrs of immunization, (L) thigh became sore, warm, red. On 7/21 erythema decreasing but still (in intensity) 13x8cm. Indurated centrally. No pain.
Age: 10.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema
Clinical narrative: Patient started to have a large round red area form of right arm where Varicella vaccine given; symptoms started 7/20/08 vaccine given 7/18/08 area 7.5cm x 7.5cm in size.
Sex: F
Vaccine: HEP
Symptoms: Autopsy, Brain oedema, Confusional state, Death, Emotional distress
Clinical narrative: This case was reported by a healthcare professional and described the occurrence of enlarged liver in a female subject (the aunt of the reporter) aged between 50 and 59 years old who was vaccinated with HEPATITIS B, manufacturer unspecified.  Concurrent medications included Thyroid replacement.  In 2004 the subject received unspecified dose of HEPATITIS B (unknown).  At an unspecified time after vaccination with HEPATITIS B, the subject complained that she was not feeling well or not feeling right (unspecified).  She was awakening with horrible dreams and she was distressed.  It was observed that the subject was confused.  She was in the bathroom saying things that made no sense and stumbling.  This was considered to be a systemic reaction.  A friend took her to the doctor and the doctor sent her to the hospital.  The hospital did a work-up.  The subject failed the neuro exams and she was hospitalized.  The events were also considered to be life threatening and clinically significant (or requiring intervention).  The subject died in the hospital an unknown amount of time later.  Initially in the hospital, the subject was thought to have Lyme disease or an inflammatory reaction, possibly an allergic reaction.  An autopsy revealed an enlarged liver and brain swelling.  Specific events of not feeling well or not feeling right, awakened with horrible nightmares and distress were said to have resolved and were considered probably related to vaccination with HEPATITIS B.  This case, A0738694A, is linked to two other cases from the same reporter.  The master case is A0738675A.  The other linked case is A0738681A.  Cases A0738675A and A0738681A are sibling cases.
Sex: F
Vaccine: HEP
Symptoms: Gait disturbance, Hepatomegaly, Incoherent, Malaise, Neurological examination abnormal
Clinical narrative: This case was reported by a healthcare professional and described the occurrence of enlarged liver in a female subject (the aunt of the reporter) aged between 50 and 59 years old who was vaccinated with HEPATITIS B, manufacturer unspecified.  Concurrent medications included Thyroid replacement.  In 2004 the subject received unspecified dose of HEPATITIS B (unknown).  At an unspecified time after vaccination with HEPATITIS B, the subject complained that she was not feeling well or not feeling right (unspecified).  She was awakening with horrible dreams and she was distressed.  It was observed that the subject was confused.  She was in the bathroom saying things that made no sense and stumbling.  This was considered to be a systemic reaction.  A friend took her to the doctor and the doctor sent her to the hospital.  The hospital did a work-up.  The subject failed the neuro exams and she was hospitalized.  The events were also considered to be life threatening and clinically significant (or requiring intervention).  The subject died in the hospital an unknown amount of time later.  Initially in the hospital, the subject was thought to have Lyme disease or an inflammatory reaction, possibly an allergic reaction.  An autopsy revealed an enlarged liver and brain swelling.  Specific events of not feeling well or not feeling right, awakened with horrible nightmares and distress were said to have resolved and were considered probably related to vaccination with HEPATITIS B.  This case, A0738694A, is linked to two other cases from the same reporter.  The master case is A0738675A.  The other linked case is A0738681A.  Cases A0738675A and A0738681A are sibling cases.
Sex: F
Vaccine: HEP
Symptoms: Nightmare, Sleep disorder
Clinical narrative: This case was reported by a healthcare professional and described the occurrence of enlarged liver in a female subject (the aunt of the reporter) aged between 50 and 59 years old who was vaccinated with HEPATITIS B, manufacturer unspecified.  Concurrent medications included Thyroid replacement.  In 2004 the subject received unspecified dose of HEPATITIS B (unknown).  At an unspecified time after vaccination with HEPATITIS B, the subject complained that she was not feeling well or not feeling right (unspecified).  She was awakening with horrible dreams and she was distressed.  It was observed that the subject was confused.  She was in the bathroom saying things that made no sense and stumbling.  This was considered to be a systemic reaction.  A friend took her to the doctor and the doctor sent her to the hospital.  The hospital did a work-up.  The subject failed the neuro exams and she was hospitalized.  The events were also considered to be life threatening and clinically significant (or requiring intervention).  The subject died in the hospital an unknown amount of time later.  Initially in the hospital, the subject was thought to have Lyme disease or an inflammatory reaction, possibly an allergic reaction.  An autopsy revealed an enlarged liver and brain swelling.  Specific events of not feeling well or not feeling right, awakened with horrible nightmares and distress were said to have resolved and were considered probably related to vaccination with HEPATITIS B.  This case, A0738694A, is linked to two other cases from the same reporter.  The master case is A0738675A.  The other linked case is A0738681A.  Cases A0738675A and A0738681A are sibling cases.
Age: 25.0
Sex: F
Vaccine: HPV4
Symptoms: Back injury, Fall, Neck injury, Syncope
Clinical narrative: Upon receiving the first dose of the HPV vaccine, I fainted in the doctor's waiting room.  I fell straight backwards and hit my back/neck on a couch in the waiting room.  I have since had problems with my neck and back.
Age: 0.5
Sex: F
Vaccine: DTAPHEPBIP, PNC
Symptoms: Abnormal behaviour, Staring
Clinical narrative: Six hours after patient received injection, mom noticed patient episodes of "staring off into space", and it continued the day after injection with frequent occurences. Has decreased since then, but still continues to have 2-3 episodes per day. Mother also noticed a change in behavior. Child now fights going to bed, and resists eating certain foods that otherwise child has eaten. Child is overall more tempermental, whereas before she was a content baby.
Age: 1.08
Sex: F
Vaccine: DTAP, HEPA, MMR, PNC, VARCEL
Symptoms: Varicella, Varicella post vaccine
Clinical narrative: Patient developed chicken pox 19 days after administration of varicella vaccine.
Age: 17.0
Sex: F
Vaccine: HPV4
Symptoms: Computerised tomogram normal, Dyskinesia, Pain in extremity, Paraesthesia
Clinical narrative: Patient received Gardasil vaccine on 7/16/2008 and subsequently was noted to have jerking movements; patient also complained of tingling and pain with her extremities.  Patient was subsequently hospitalized where she was evaluated and monitored. 8/21/08-ED records received for DOS 7/22/08-Presented with C/O burning sensation in chest, headache and feeling funny. facial swelling and hand swelling began yesterday. Pain in both legs with headache. Movement disorder twitching movements. Neuro consult observed episodes of shoulder shrugging. Impression: conversion disorder.
Sex: U
Vaccine: VARCEL
Symptoms: Herpes zoster
Clinical narrative: My father had the shingles vaccine and a week later was with my 12 year old daughter.  She has had chicken pox as a 2 year old.  She came down with shingles 4 days after being around my father.
Age: 0.5
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Rash
Clinical narrative: Shortly after injection rash occurs, this time we pre  treated him with benadryl and he still had a rash within minutes after injections
Age: 29.0
Sex: M
Vaccine: HEP
Symptoms: Rash generalised
Clinical narrative: Received HEP B shot when series was already complete.  20JUL - Small rash near injection site.  21JUL - rash quickly spread over legs, arms and torso.  ER visit, was given 60mg of 'anti-allergine'? resulted in rash dispating. 22JUL Rash recovered and spreading over entire body.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Unevaluable event
Clinical narrative: Mother presented to clinic with child for "school shots". Most recent copy of child immunization card revealed that shots were needed. When mom asked for her blue card she reports that it is in the car. Immunizations were given and mother returned to clinic room so that today's shots could be added. Card showed documentation that child was actually up to date and did not need the vaccines today.  Mom notiified and was counseled to always present card to vaccine administrators prior to any vaccines being received in the future to avoid future duplication and unecessary vaccinations for the child.
Age: 51.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Activated partial thromboplastin time, C-reactive protein normal, CSF cell count normal, Full blood count abnormal, Gait disturbance
Clinical narrative: EMPLOYEE DESCRIBES NUMBNESS TO BILATERAL LEGS ON 7-07-08. STARTED HAVING WALKING DIFFICULTY ON 7-8-08 - 7-09-08.  HOSPITALIZED ON 7-09-08 UNTIL PRESENT. 7/30/08-records received for DOS 7/9/08-admitted with back pain subsequent development of numbness in both legs, lower back, difficulty walking and urinary incontinence with no bowel movement for past 2 days. Presented on 7/8/08. Symptoms started 3 days before admission.  PE:Romberg positive, weakness left lower extremity, sensory exam reduced vibration up to both knees. 8/7/08-DC Summary received for DOS 7/9-7/23/08-DC DX: T6 sensory level neurologic deficit with neurogenic bladder and fever, rule out acute transverse myelitis, rule out Guillain-Barre. Obstructive sleep apnea on CPAP.  8/27/08-CDC's CISA staff reviewed this case and determined that it is Transverse Myelitis and not GBS.
Age: 51.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Hepatitis B surface antigen negative, Hepatitis C antibody negative, Hypoaesthesia, International normalised ratio normal, Laboratory test abnormal
Clinical narrative: EMPLOYEE DESCRIBES NUMBNESS TO BILATERAL LEGS ON 7-07-08. STARTED HAVING WALKING DIFFICULTY ON 7-8-08 - 7-09-08.  HOSPITALIZED ON 7-09-08 UNTIL PRESENT. 7/30/08-records received for DOS 7/9/08-admitted with back pain subsequent development of numbness in both legs, lower back, difficulty walking and urinary incontinence with no bowel movement for past 2 days. Presented on 7/8/08. Symptoms started 3 days before admission.  PE:Romberg positive, weakness left lower extremity, sensory exam reduced vibration up to both knees. 8/7/08-DC Summary received for DOS 7/9-7/23/08-DC DX: T6 sensory level neurologic deficit with neurogenic bladder and fever, rule out acute transverse myelitis, rule out Guillain-Barre. Obstructive sleep apnea on CPAP.  8/27/08-CDC's CISA staff reviewed this case and determined that it is Transverse Myelitis and not GBS.
Age: 51.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Lumbar puncture abnormal, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain normal, Prothrombin time normal, Red blood cell sedimentation rate normal
Clinical narrative: EMPLOYEE DESCRIBES NUMBNESS TO BILATERAL LEGS ON 7-07-08. STARTED HAVING WALKING DIFFICULTY ON 7-8-08 - 7-09-08.  HOSPITALIZED ON 7-09-08 UNTIL PRESENT. 7/30/08-records received for DOS 7/9/08-admitted with back pain subsequent development of numbness in both legs, lower back, difficulty walking and urinary incontinence with no bowel movement for past 2 days. Presented on 7/8/08. Symptoms started 3 days before admission.  PE:Romberg positive, weakness left lower extremity, sensory exam reduced vibration up to both knees. 8/7/08-DC Summary received for DOS 7/9-7/23/08-DC DX: T6 sensory level neurologic deficit with neurogenic bladder and fever, rule out acute transverse myelitis, rule out Guillain-Barre. Obstructive sleep apnea on CPAP.  8/27/08-CDC's CISA staff reviewed this case and determined that it is Transverse Myelitis and not GBS.
Age: 51.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Urine analysis abnormal
Clinical narrative: EMPLOYEE DESCRIBES NUMBNESS TO BILATERAL LEGS ON 7-07-08. STARTED HAVING WALKING DIFFICULTY ON 7-8-08 - 7-09-08.  HOSPITALIZED ON 7-09-08 UNTIL PRESENT. 7/30/08-records received for DOS 7/9/08-admitted with back pain subsequent development of numbness in both legs, lower back, difficulty walking and urinary incontinence with no bowel movement for past 2 days. Presented on 7/8/08. Symptoms started 3 days before admission.  PE:Romberg positive, weakness left lower extremity, sensory exam reduced vibration up to both knees. 8/7/08-DC Summary received for DOS 7/9-7/23/08-DC DX: T6 sensory level neurologic deficit with neurogenic bladder and fever, rule out acute transverse myelitis, rule out Guillain-Barre. Obstructive sleep apnea on CPAP.  8/27/08-CDC's CISA staff reviewed this case and determined that it is Transverse Myelitis and not GBS.
Age: 51.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Activated partial thromboplastin time normal, Blood product transfusion, C-reactive protein normal, CSF cell count normal, Chest X-ray normal
Clinical narrative: EMPLOYEE DESCRIBES NUMBNESS TO BILATERAL LEGS ON 7-07-08. STARTED HAVING WALKING DIFFICULTY ON 7-8-08 - 7-09-08.  HOSPITALIZED ON 7-09-08 UNTIL PRESENT. 7/30/08-records received for DOS 7/9/08-admitted with back pain subsequent development of numbness in both legs, lower back, difficulty walking and urinary incontinence with no bowel movement for past 2 days. Presented on 7/8/08. Symptoms started 3 days before admission.  PE:Romberg positive, weakness left lower extremity, sensory exam reduced vibration up to both knees. 8/7/08-DC Summary received for DOS 7/9-7/23/08-DC DX: T6 sensory level neurologic deficit with neurogenic bladder and fever, rule out acute transverse myelitis, rule out Guillain-Barre. Obstructive sleep apnea on CPAP.  8/27/08-CDC's CISA staff reviewed this case and determined that it is Transverse Myelitis and not GBS.
Age: 51.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Full blood count abnormal, Gait disturbance, Hepatitis B surface antigen negative, Hepatitis C antibody negative, Hypoaesthesia
Clinical narrative: EMPLOYEE DESCRIBES NUMBNESS TO BILATERAL LEGS ON 7-07-08. STARTED HAVING WALKING DIFFICULTY ON 7-8-08 - 7-09-08.  HOSPITALIZED ON 7-09-08 UNTIL PRESENT. 7/30/08-records received for DOS 7/9/08-admitted with back pain subsequent development of numbness in both legs, lower back, difficulty walking and urinary incontinence with no bowel movement for past 2 days. Presented on 7/8/08. Symptoms started 3 days before admission.  PE:Romberg positive, weakness left lower extremity, sensory exam reduced vibration up to both knees. 8/7/08-DC Summary received for DOS 7/9-7/23/08-DC DX: T6 sensory level neurologic deficit with neurogenic bladder and fever, rule out acute transverse myelitis, rule out Guillain-Barre. Obstructive sleep apnea on CPAP.  8/27/08-CDC's CISA staff reviewed this case and determined that it is Transverse Myelitis and not GBS.
Age: 51.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: International normalised ratio normal, Laboratory test abnormal, Lumbar puncture abnormal, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain normal
Clinical narrative: EMPLOYEE DESCRIBES NUMBNESS TO BILATERAL LEGS ON 7-07-08. STARTED HAVING WALKING DIFFICULTY ON 7-8-08 - 7-09-08.  HOSPITALIZED ON 7-09-08 UNTIL PRESENT. 7/30/08-records received for DOS 7/9/08-admitted with back pain subsequent development of numbness in both legs, lower back, difficulty walking and urinary incontinence with no bowel movement for past 2 days. Presented on 7/8/08. Symptoms started 3 days before admission.  PE:Romberg positive, weakness left lower extremity, sensory exam reduced vibration up to both knees. 8/7/08-DC Summary received for DOS 7/9-7/23/08-DC DX: T6 sensory level neurologic deficit with neurogenic bladder and fever, rule out acute transverse myelitis, rule out Guillain-Barre. Obstructive sleep apnea on CPAP.  8/27/08-CDC's CISA staff reviewed this case and determined that it is Transverse Myelitis and not GBS.
Age: 51.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Nuclear magnetic resonance imaging normal, Prothrombin time normal, Red blood cell sedimentation rate normal, Urine analysis abnormal
Clinical narrative: EMPLOYEE DESCRIBES NUMBNESS TO BILATERAL LEGS ON 7-07-08. STARTED HAVING WALKING DIFFICULTY ON 7-8-08 - 7-09-08.  HOSPITALIZED ON 7-09-08 UNTIL PRESENT. 7/30/08-records received for DOS 7/9/08-admitted with back pain subsequent development of numbness in both legs, lower back, difficulty walking and urinary incontinence with no bowel movement for past 2 days. Presented on 7/8/08. Symptoms started 3 days before admission.  PE:Romberg positive, weakness left lower extremity, sensory exam reduced vibration up to both knees. 8/7/08-DC Summary received for DOS 7/9-7/23/08-DC DX: T6 sensory level neurologic deficit with neurogenic bladder and fever, rule out acute transverse myelitis, rule out Guillain-Barre. Obstructive sleep apnea on CPAP.  8/27/08-CDC's CISA staff reviewed this case and determined that it is Transverse Myelitis and not GBS.
Age: 6.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Erythema
Clinical narrative: Redness on lateral aspect of right arm of 6cm x 3cm. No vesicles, pustuals, crusted or oozing lesions where seen.
Age: 21.0
Sex: M
Vaccine: SMALL
Symptoms: Dysgeusia, Dyskinesia, Eyelid disorder, Facial palsy
Clinical narrative: Patient given anthrax and typhoid on 15 Jul 2008. Followed by smallpox on 16 Jul 2008. Noticed metallic taste on 17/18 Jul 08. Morning of 19 Jul 08, noted right sided facial changes.  By 20 Jul 08, noted crooked smile and difficulty closing right eye. Seen in ER on 21 Jul 08 and diagnosed with Bells Palsy. Started on acyclovir 400 mg TID x 10 days.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Lymphadenopathy, Pyrexia
Clinical narrative: Had swollen Lymph Nodes in neck area starting on 7/20/2008 along with fever on 7/20/2008 with highest fever of 102.4. Today, 7/22/2008 no fever and lymph nodes remain slightly swollen.
Age: 11.0
Sex: F
Vaccine: VARCEL
Symptoms: Diarrhoea, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: 10 minutes after vaccination, site became itchy.  8 hours after, had diarrhea.  24 hours after, site became raised, continues to be itchy, and is warm to touch.
Age: 48.0
Sex: M
Vaccine: ANTH
Symptoms: Laboratory test, Lymphadenopathy, Rash
Clinical narrative: Two bumps at right ear.Swollen lymph node on right side right next to bumps.
Age: 35.0
Sex: F
Vaccine: TDAP
Symptoms: Dyspnoea, Heart rate increased, Joint stiffness, Nausea, Throat tightness
Clinical narrative: Pt. developed jaw and throat tightness, nausea, rapid heart beat and difficulty breathing approximately 20 minutes after receiving Tdap immunization and Mantoux test. 911 responded and transported her to the local ED where she was given Benadryl, a steroid, and Zantac. An EKG was normal. She was discharged with Rx for Benadryl, Prednisone and Allegra.
Age: 19.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Musculoskeletal pain
Clinical narrative: Pt had a tdap in her left deltoid muscle on 7/15/08 at school.  She reported her typical injection pain.  On the 5th day after the immunzation, pt developed +redness, +itching, +warmth.  She presented to school on 7/22/08 for Mumps (dose 2), varicella (dose 2) and ppd.  Immunizations were deferred due to left shoulder pain.
Age: 1.08
Sex: M
Vaccine: VARCEL
Symptoms: Varicella
Clinical narrative: DX WITH CHICKEN POX ON 7/21/2008
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Blister, Erythema, Herpes zoster, Pain, Pruritus
Clinical narrative: Patient received zostavax on 7/9/08. Patient developed a itchy area left side of abdomen 2 days after injection.  Then a vesicle red rash appeared 2 days later.  The rash is painful when scratched.  Patient came into clinic 7/22/08 and a diagnosis of shingles was made.
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Patient received zostavax on 7/9/08. Patient developed a itchy area left side of abdomen 2 days after injection.  Then a vesicle red rash appeared 2 days later.  The rash is painful when scratched.  Patient came into clinic 7/22/08 and a diagnosis of shingles was made.
Age: 54.0
Sex: F
Vaccine: HEP
Symptoms: Erythema, Rash, Rash pruritic, Skin swelling
Clinical narrative: Had rash on legs and arms not on trunk. Rash was small raised red and puritic. Had Cortisone injection earlier in the week. Called private MD who stated rash probably due to Hepatitis B and not Cortisone. Did not experience difficulty breathing, hoarseness wheezing, hives, paleness, weakness, fast heart rate or dizziness. No fever.
Age: 7.0
Sex: M
Vaccine: DTAP, MMR
Symptoms: Wrong drug administered
Clinical narrative: On January 16, 2008, Pt was given DTaP instead of Td.  Error was discovered 07/17/2008.
Age: 93.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site swelling, Leukocytosis, Sepsis, White blood cell count increased
Clinical narrative: Redness and swelling at site in deltoid muscle area and in a large area encompassing most of the upper arm. She developed sepsis symptoms and marked leukocytosis - wbc 21,000.  8/13/2008 MR received for DOS 7/19-21/2008 with D/C DX:  Cellulitis of the Right upper arm sequela of recent Pneumovax injection with sepsis syndrome. Dehydration and pre-renal azotemia.  Persistant right shoulder pain limitation of range of motion of right shoulder.  Anemia of uncertain etiology.  Pt presented to the ER with hx of feeling poorly since recent Pneumovax injection. Pt developed redness, swelling and pain of the right arm with decreased ability to move the arm 2' to pain. Pt has also felt weak with decreased appetite. Admitted for sepsis syndrome with marked leukocytosis. Tx with IVF and abx with improvement in all but shoulder ROM.
Age: 18.0
Sex: M
Vaccine: MNQ
Symptoms: Fall, Head injury, Loss of consciousness
Clinical narrative: Nurse administered Menactra vaccine to patient.  Nurse left room to obtain vaccine card for patient to keep.  Was gone approximately one minute and on the way back to the patient room she heard a thump.  Patient had passed out and was lying on the floor.  He was coming to as she entered the room.  Patient had visible area on forehead where he had fallen and hit it.  The physician was notified and examined patient.  Patient was kept at clinic approximately 45 minutes and vitals were monitored.  He was examined again by the nurse practitioner before leaving the clinic.
Age: 12.0
Sex: M
Vaccine: HEPA, MNQ, TDAP, VARCEL
Symptoms: Injection site scar, Injection site vesicles
Clinical narrative: Was given Varicella vaccine in RA sub-q.  1 day later he had a very large 1" blister at site of injection and within 1 week had scarring, which he still has.
Age: 50.0
Sex: M
Vaccine: PPV
Symptoms: Arthralgia, Cold sweat, Feeling hot, Nausea, Oedema peripheral
Clinical narrative: Joint aches, nausea, arm swelling/local pain, feverish, cold sweats.
Age: 50.0
Sex: M
Vaccine: PPV
Symptoms: Pain
Clinical narrative: Joint aches, nausea, arm swelling/local pain, feverish, cold sweats.
Age: 15.0
Sex: F
Vaccine: HPV4, MNQ, TD
Symptoms: Blindness, Blood test, Computerised tomogram, Convulsion, Dizziness
Clinical narrative: Approximately 10 minutes after the shot, while still in the doctors office, patient experienced a seizure, incontinence, headache, temporary peripheral vision loss in right eye, vomiting, dizziness.  Required emergency room visit via ambulance.  Received anti-nausea drugs via IV to end vomiting.  Released from the hospital later that night.
Age: 15.0
Sex: F
Vaccine: HPV4, MNQ, TD
Symptoms: Headache, Incontinence, Visual field defect, Vomiting
Clinical narrative: Approximately 10 minutes after the shot, while still in the doctors office, patient experienced a seizure, incontinence, headache, temporary peripheral vision loss in right eye, vomiting, dizziness.  Required emergency room visit via ambulance.  Received anti-nausea drugs via IV to end vomiting.  Released from the hospital later that night.
Age: 0.2
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood culture negative, C-reactive protein increased, CSF culture negative
Clinical narrative: Pt admitted with episodes of acholic stools. Pt had fever in ED. Pt had labs drawn and it showed elevated AST and ALT. Pt given Acyclovir and IVF. Pt had a rule out sepsis work up done. Pt's CSF labs were slightly abnormal. HSV (-). Pt's stools are normal in consistency and color prior to discharge and parent is comfortable with going home.  3/24/2008 VAERS report received with MR included for DOS 7/9-11/2008 with D/C DX:  Acholic stools, fever, transaminitis. Pt presented with multiple episodes of white, pasty stools preceded by 1 blackish stool, fever and being sleepier than usual. Admitted for sepsis w/u where elevated transaminases were found. Tx with Acyclovir until cx came back (-). LFTs improved with normal stool by d/c.
Age: 0.2
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: CSF protein increased, Culture stool negative, Faeces pale, Gamma-glutamyltransferase, Herpes simplex serology negative
Clinical narrative: Pt admitted with episodes of acholic stools. Pt had fever in ED. Pt had labs drawn and it showed elevated AST and ALT. Pt given Acyclovir and IVF. Pt had a rule out sepsis work up done. Pt's CSF labs were slightly abnormal. HSV (-). Pt's stools are normal in consistency and color prior to discharge and parent is comfortable with going home.  3/24/2008 VAERS report received with MR included for DOS 7/9-11/2008 with D/C DX:  Acholic stools, fever, transaminitis. Pt presented with multiple episodes of white, pasty stools preceded by 1 blackish stool, fever and being sleepier than usual. Admitted for sepsis w/u where elevated transaminases were found. Tx with Acyclovir until cx came back (-). LFTs improved with normal stool by d/c.
Age: 0.2
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Laboratory test abnormal, Protein urine present, Pyrexia, Red blood cells CSF positive
Clinical narrative: Pt admitted with episodes of acholic stools. Pt had fever in ED. Pt had labs drawn and it showed elevated AST and ALT. Pt given Acyclovir and IVF. Pt had a rule out sepsis work up done. Pt's CSF labs were slightly abnormal. HSV (-). Pt's stools are normal in consistency and color prior to discharge and parent is comfortable with going home.  3/24/2008 VAERS report received with MR included for DOS 7/9-11/2008 with D/C DX:  Acholic stools, fever, transaminitis. Pt presented with multiple episodes of white, pasty stools preceded by 1 blackish stool, fever and being sleepier than usual. Admitted for sepsis w/u where elevated transaminases were found. Tx with Acyclovir until cx came back (-). LFTs improved with normal stool by d/c.
Age: 19.0
Sex: F
Vaccine: HEP
Symptoms: Nausea
Clinical narrative: Became nauseated approx 4-5 cm after shot and were still feelin nauseated the day after.
Age: 19.0
Sex: F
Vaccine: TYP
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: I gave an order for a Typhoid shot and she had already had one.  No adverse reaction noted.
Age: 47.0
Sex: F
Vaccine: TDAP
Symptoms: Body temperature increased, Headache, Nausea, Oedema peripheral, Pain
Clinical narrative: temp of 104, swelling from my site to below elbow, N+V, headache, body aches.
Age: 47.0
Sex: F
Vaccine: TDAP
Symptoms: Vomiting
Clinical narrative: temp of 104, swelling from my site to below elbow, N+V, headache, body aches.
Age: 15.0
Sex: M
Vaccine: MNQ
Symptoms: Unevaluable event
Clinical narrative: Pt's mother called and notified. No adverse reaction noted. She will monitor for any.
Age: 76.0
Sex: M
Vaccine: VARZOS
Symptoms: Herpes zoster, Rash
Clinical narrative: 7/16 received ZOSTAVAX. 7/21 broke out in rash-classic shingles appearance ((L) T.O dermatome) elected against antiviral Rx
Age: 0.18
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Anaemia, Anoxia, Brain scan normal, Breath holding, Cardiac murmur
Clinical narrative: Breath holding spells with a fainting spell followed by a brief anoxic seizure single episode triggered by crying fit. 7/29/08-records received for DOS 07/29-07/30/07-Life threatening event.  This is first seizure related to cyanotic breath holding spells. In ED had another spell when IV insertion took place. No spells that are unprovoked. PE:WNL. Assessment:breath holding spells with a fainting spell and brief anoxic seizure.
Age: 0.18
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Computerised tomogram normal, Convulsion, Crying, Electroencephalogram normal, Scan brain
Clinical narrative: Breath holding spells with a fainting spell followed by a brief anoxic seizure single episode triggered by crying fit. 7/29/08-records received for DOS 07/29-07/30/07-Life threatening event.  This is first seizure related to cyanotic breath holding spells. In ED had another spell when IV insertion took place. No spells that are unprovoked. PE:WNL. Assessment:breath holding spells with a fainting spell and brief anoxic seizure.
Age: 15.0
Sex: M
Vaccine: MMR, MNQ
Symptoms: Dizziness, Nausea
Clinical narrative: Pt received PPD, MENACTRA and MMR. Non-english speaking. Indicates with hand "spinning". Via translator nauseated. no emesis. Rested in clinic x 20 min. Given water and juice.
Age: 21.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Abasia, Asthenia, Blood test, Chromosomal analysis, Computerised tomogram
Clinical narrative: neuromuscular pain, global weakness, intermittant swelling.  07/23/2008 MR received for DOS 10/19/2007 which include 2 Rheumatology consults, neuro consult, psych consult. Pt presented for Rheum eval 10/19/08 with c/o 6 week hx of pain and sensitivity in her face, jaw neck and thoracic region (burning & tingling) and progressive weakness in her limbs.  Unable to walk without assistance. Pt reports dizziness, vertigo, syncope and photosensitivity. Sleep is disturbed. Several falls. Has sweats. Presents in sunglasses for photophobia and in a w/c. This followed a viral and /or sinus infection 6 weeks prior. PE (+) for anceiform rash on the back, scalp, face, jaw, and neck tenderness, DTRs 1+ arms, unobtainable in legs, decreased strength in arms and legs, unable to walk.  Concern for neurological illness resulted in emergent admission to hospital for further eval. DOS 10/19-24/2007 with DX: weakness.  other dx:  fibromyalgia, migraines, asthma and chronic pain syndrome. Neuro consult as above but able to elicit patellar reflexes. Psych eval to r/o conversion d/o. Requested further eval. 2nd Rheum consult for increased sed rate. Additional sx of touch sensitivity and lower extremity numbness.  Impression:  Elevated Sed rate.  Myalgia and myositis NOS, Headache, Difficulty in walking. Pt had some nausea and vomiting while admitted.  Treated for pain and pt was ambulating on her own by d/c.  No final dx made.  D/C to f/u at home.
Age: 21.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Disability, Dizziness, Eating disorder, Electroencephalogram, Electromyogram
Clinical narrative: neuromuscular pain, global weakness, intermittant swelling.  07/23/2008 MR received for DOS 10/19/2007 which include 2 Rheumatology consults, neuro consult, psych consult. Pt presented for Rheum eval 10/19/08 with c/o 6 week hx of pain and sensitivity in her face, jaw neck and thoracic region (burning & tingling) and progressive weakness in her limbs.  Unable to walk without assistance. Pt reports dizziness, vertigo, syncope and photosensitivity. Sleep is disturbed. Several falls. Has sweats. Presents in sunglasses for photophobia and in a w/c. This followed a viral and /or sinus infection 6 weeks prior. PE (+) for anceiform rash on the back, scalp, face, jaw, and neck tenderness, DTRs 1+ arms, unobtainable in legs, decreased strength in arms and legs, unable to walk.  Concern for neurological illness resulted in emergent admission to hospital for further eval. DOS 10/19-24/2007 with DX: weakness.  other dx:  fibromyalgia, migraines, asthma and chronic pain syndrome. Neuro consult as above but able to elicit patellar reflexes. Psych eval to r/o conversion d/o. Requested further eval. 2nd Rheum consult for increased sed rate. Additional sx of touch sensitivity and lower extremity numbness.  Impression:  Elevated Sed rate.  Myalgia and myositis NOS, Headache, Difficulty in walking. Pt had some nausea and vomiting while admitted.  Treated for pain and pt was ambulating on her own by d/c.  No final dx made.  D/C to f/u at home.
Age: 21.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Facial palsy, Gastrointestinal disorder, Gene mutation identification test, Hair metal test, Headache
Clinical narrative: neuromuscular pain, global weakness, intermittant swelling.  07/23/2008 MR received for DOS 10/19/2007 which include 2 Rheumatology consults, neuro consult, psych consult. Pt presented for Rheum eval 10/19/08 with c/o 6 week hx of pain and sensitivity in her face, jaw neck and thoracic region (burning & tingling) and progressive weakness in her limbs.  Unable to walk without assistance. Pt reports dizziness, vertigo, syncope and photosensitivity. Sleep is disturbed. Several falls. Has sweats. Presents in sunglasses for photophobia and in a w/c. This followed a viral and /or sinus infection 6 weeks prior. PE (+) for anceiform rash on the back, scalp, face, jaw, and neck tenderness, DTRs 1+ arms, unobtainable in legs, decreased strength in arms and legs, unable to walk.  Concern for neurological illness resulted in emergent admission to hospital for further eval. DOS 10/19-24/2007 with DX: weakness.  other dx:  fibromyalgia, migraines, asthma and chronic pain syndrome. Neuro consult as above but able to elicit patellar reflexes. Psych eval to r/o conversion d/o. Requested further eval. 2nd Rheum consult for increased sed rate. Additional sx of touch sensitivity and lower extremity numbness.  Impression:  Elevated Sed rate.  Myalgia and myositis NOS, Headache, Difficulty in walking. Pt had some nausea and vomiting while admitted.  Treated for pain and pt was ambulating on her own by d/c.  No final dx made.  D/C to f/u at home.