Age: 1.25
Sex: M
Vaccine: DTAP
Symptoms: Ketoacidosis, Pyrexia, Rash, Respiratory rate increased, Vomiting
Clinical narrative: On Wednesday, June 12th, when pt got up in the middle of the night for a bottle, I noticed that he was running a fever. I gave him some Motrin, which he threw up. Later I tried some Tylenol, which he threw up. Finally I put some Tylenol in a bottle of juice, which he kept down; although he threw up several more times that day. By Friday he wasn't running a fever, but threw up after I let him consume some milk products.  He was looking quite bad and had visibly lost weight. He was also crying in a way that I wondered if it were more than a virus. So I took him into the pediatrician's office. The pediatrician was concerned that he was starting to look dehydrated, but said that he wasn't clinically dehydrated yet (partly because he was still having wet diapers) and told me to give him Gatoraid. He gave pt a shot of phenegran so that he would stop vomiting. Saturday pt spent the entire day either on my hip or on the sofa. He was so sick he could hardly hold his head up. But he was drinking the Gatoraid and having lots of wet diapers. In the middle of the night he started breathing rapidly and deeply, which I was very concerned about. Sunday morning (Father's Day) his breathing was still rapid and labored.  He also started throwing up again, he was looking really bad, had clearly lost more weight, and couldn't hold his head up. So, I took him into the pediatrician's office again (they have limited office hours on the weekends). The pediatrician who saw him, made the diagnosis of Diabetes Type 1, Ketoacidosis, and dehydration very quickly and sent me to the local ICU. After they started the IVs, they contacted Hospital to arrange for their ICU transport team to fly us there. When the ICU transport team arrived, they did lots of things including inserting a catheter. When they did this they noticed that pt had a rash and asked me how long he had had the rash. I knew when the rash had appeared because it happened at the end of what I had considered a very bad reaction to the DTaP vaccination that pt had received at his 15 month well check.His well check was on Thrus, 4/25. On the following Saturday morning, 4/27, he took his nap early (and I wondered if he was unwell) he woke a short time later with a fever and proceeded to cry for most of the next 40 hrs (almost all of the waking time, and he slept very little during that period). The last 3 hrs (carly, early Monday morning) he screamed and screamed, and his little body flinched several times. I had contacted the pediatrician's office that Sunday too. I spoke with the nurse about 4 or 5 times, she agreed with me that it sounded like a reaction to the vaccination, but the doctor on call thought it was probably viral and so they didn't see him. By Monday, pt and I were both exhausted. He was no longer screaming, but was rather dazed. I can't remember exactly how long he was in this dazed state, but it was at least several days, possibly a week; after which he returned basically to his normal self, although seemed fussier at times and more clingy. THe rash had started in his diaper area on either that Sunday or Monday (the 28th or 29th of April), spread to his torso, arms, and legs (although was always worst in the diaper area), and then by the following week had gone away with the exception of in the diaper area. I tried many things to get rid of the rash; but I couldn't get ird of it because, as the ICU transport team's doctor explained to me, it was actually a yeast infection that was probably caused by the sugar in his urine. Pt spent five days in pediatric ICU. Please noe that in regards to question 13 below, the vaccine was DTaP with the lot number indicated below. However, my records do not indicate if it was Tripedia, Daptacel or another variation. perhaps you will be able to determine that by the lot number. Also, in answer to question 21 below, I remember that pt became quite sick after a flu shot that he received in November of 2001. This injection is not on my record sheet and I am not sure which particular flu shot was given at that time. When I talked to the nurst at the time, she thought he might have picked up a virus around the time he got the flu shot.