chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 7.0
Sex: M
Vaccine: PPV
Symptoms: Injection site induration, Injection site mass, Injection site pain, Pyrexia
Clinical narrative: Information has been received from consumer concerning her 7 year old son with asthma and seasonal allergy who on 04/19/04 was vaccinated in the right arm with a dose of pneumococcal 23v polysaccharide vaccine (Lot # 647655/0869N).  Concomitant therapy included cetirizine hydrochloride (Zyrtec) and montelukast sodium (Singulair).  Prior to vaccination the pt was treated for chronic sinus infection with amoxicillin/clavulanate potassium (Augmentin) 875mg and an unspecified steroid for duration of 20 days.  On the night of vaccination, the pt woke with fever 104F, screaming in pain from a large, hard, red, hot golf ball size area on his upper right arm at the injection site.  He was treated with tub baths, acetaminophen (Tylenol) and ibuprofen (Advil).  On 04/20/04 he was seen in the office and a chest x-ray and CBC were performed.  The pt's fever continued and he also had a deep cough and headache.  The physician called to confirm that the pt was treated with amoxicillin/clavulanate potassium (Augmentin) and the medication was finished on 04/16/04.  He also confirmed that the pt had a severe local reaction and cough as per his visit on 04/20/04.  There was no chest x-ray report yet and CBC results included; WBC 13,000 and neutrophils 80% with 2% bands.  He reported that the child would be seen again on 04/21/04 and would probably be restarted on amoxicillin/clavulanate potassium (Augmentin).  The pt had no previous reaction to vaccinations and did not receive pneumococcal 4 6B 9V 14 18C 19F 23F conj vaccine (crm197) (Prevnar) in the past.  There was no product quality complaint involved.  Additional information from the pt's mother on 04/23/04 indicated that the pt had cellulitis of the affected arm.  He was not able to move it and his arm is in a sling.  He continues his amoxicillin/clavulanate potasssium (Augmentin) and will be seen by his doctor again today, 04/23/04.  The pt's mother reported that "the area of the injection was not cleansed prior to the injection by the allergists nurse".  Her son also had "15 allergy tests in the other arm on the same day as the vaccination and the syringe with the (pneumococcal 23v polysaccharide vaccine) was carried on the same tray as the allergy test syringes".  Upon internal review, cellulitis and not able to move his arm were determined to be other important medical events (OMIC).  Additional information has been requested.
Age: 21.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Cardiovascular disorder, Chest pain, Myocarditis, Rhabdomyolysis
Clinical narrative: Pt received smallpox vaccination at 09:00, 04/18/04.  Pt reported to tER at 18:00 on 04/08/04 with chest pain.  Pt was admitted to hospital with possible myocarditis or myopericarditis.  Pt also received Anthrax vaccination.  Nurse follow up on 06/17/04 states: "Per review of hospital d/c summary, please add to Box 7 rhabdomyolysis (RHABDO), mitral regurgitation and tricuspid regurgitation (CARDIOVASC DIS). The impression in ER was myocarditis and chest pain, but final diagnosis was rhabdomyolysis with a secondary diagnosis of chest pain."
Age: 3.0
Sex: F
Vaccine: HEP
Symptoms: Arthralgia, Asthenia, Diarrhoea, Difficulty in walking, Laboratory test abnormal
Clinical narrative: 04/04/03: Vomited early morning; 04/06/03: Hives on cheeks and itching, diarrhea, fever; 04/11/03: Fever 103F, same symptoms and joint aches, went to MD told viral; 04/18/03: Fever 103F, can't walk, weak, diarrhea, hives, ER, told viral; 04/21/04: Hospitalization; 04/26/04: Hospitalization, told had juvenile arthritis.    Nurse follow up on 05/18/04 states: "ADD: juvenile rheumatoid --   arthritis rheumat arthritis .Delete: arthritis."  06/09/2005: patient has not recovered.  Patient has juvenile rhuematoid arthritis, autoimmune hemolytic anemia.  Symptoms include anemia, joint pain to the point sometimes patient is unable to walk.
Age: 3.0
Sex: F
Vaccine: HEP
Symptoms: Pruritus, Pyrexia, Rheumatoid arthritis, Urticaria, Viral infection
Clinical narrative: 04/04/03: Vomited early morning; 04/06/03: Hives on cheeks and itching, diarrhea, fever; 04/11/03: Fever 103F, same symptoms and joint aches, went to MD told viral; 04/18/03: Fever 103F, can't walk, weak, diarrhea, hives, ER, told viral; 04/21/04: Hospitalization; 04/26/04: Hospitalization, told had juvenile arthritis.    Nurse follow up on 05/18/04 states: "ADD: juvenile rheumatoid --   arthritis rheumat arthritis .Delete: arthritis."  06/09/2005: patient has not recovered.  Patient has juvenile rhuematoid arthritis, autoimmune hemolytic anemia.  Symptoms include anemia, joint pain to the point sometimes patient is unable to walk.
Age: 3.0
Sex: F
Vaccine: HEP
Symptoms: Vomiting
Clinical narrative: 04/04/03: Vomited early morning; 04/06/03: Hives on cheeks and itching, diarrhea, fever; 04/11/03: Fever 103F, same symptoms and joint aches, went to MD told viral; 04/18/03: Fever 103F, can't walk, weak, diarrhea, hives, ER, told viral; 04/21/04: Hospitalization; 04/26/04: Hospitalization, told had juvenile arthritis.    Nurse follow up on 05/18/04 states: "ADD: juvenile rheumatoid --   arthritis rheumat arthritis .Delete: arthritis."  06/09/2005: patient has not recovered.  Patient has juvenile rhuematoid arthritis, autoimmune hemolytic anemia.  Symptoms include anemia, joint pain to the point sometimes patient is unable to walk.
Age: 41.0
Sex: M
Vaccine: SMALL
Symptoms: Erythema, Erythema multiforme, Pruritus, Vaccination complication
Clinical narrative: Auto inoculation to left hand, erythema, intense itching, rash (Erythema multiforme) , onset approx. 7-10 days after vaccination. Tx with Ataract, Darvocet, Allegra
Age: 43.0
Sex: M
Vaccine: ANTH
Symptoms: Erythema, Feeling hot, Injection site oedema, Pruritus, Tenderness
Clinical narrative: Right deltoid-Large area redness and swelling 100-120mm not extending below elbow. Area warm to touch, tender, itching, cortizone OTC cream applied by patient, now on Tylenol prn and Benadryl OTC with effect
Age: 34.0
Sex: F
Vaccine: FLU3, HEPA, TD
Symptoms: Dizziness, Fatigue, Hypersensitivity, Hypoxia, Oedema peripheral
Clinical narrative: See attached clinical summary. Reports being in good health with no prior adverse reactions to any previous immunization until November 2, 2002. She received 3 immunizations and a PPD (Hepatitis A #2, Influenza and Td) the morning of November 2nd, without apparent incident. States that approximately 30 minutes later recalls, a tingling feeling, a slight itchy in the throat and feeling tired, so went to lie down. Later that afternoon, @2:30PM noted itchiness on arms and neck followed by a generalized rash with hives and welts on the neck arms, chest and back. Also had swelling of the face and hands. Denies wheezing, fever, nausea or vomiting, but says tongue felt swollen and throat felt tight and felt woozy. Was seen in the clinic and immediately sent to the ER. Once there was given Benadryl 50mg IM, received IV fluids, O2, and observed until the symptoms began to subside. Was released on oral prednisone and given a referral to be evaluated by an Allergist. Subsequently under went skin testing that demonstrated positive reactions to trees, grass and weeds, but did not address vaccine allergies and or desensitization.
Age: 34.0
Sex: F
Vaccine: FLU3, HEPA, TD
Symptoms: Paraesthesia, Pruritus, Rash, Swelling, Swelling face
Clinical narrative: See attached clinical summary. Reports being in good health with no prior adverse reactions to any previous immunization until November 2, 2002. She received 3 immunizations and a PPD (Hepatitis A #2, Influenza and Td) the morning of November 2nd, without apparent incident. States that approximately 30 minutes later recalls, a tingling feeling, a slight itchy in the throat and feeling tired, so went to lie down. Later that afternoon, @2:30PM noted itchiness on arms and neck followed by a generalized rash with hives and welts on the neck arms, chest and back. Also had swelling of the face and hands. Denies wheezing, fever, nausea or vomiting, but says tongue felt swollen and throat felt tight and felt woozy. Was seen in the clinic and immediately sent to the ER. Once there was given Benadryl 50mg IM, received IV fluids, O2, and observed until the symptoms began to subside. Was released on oral prednisone and given a referral to be evaluated by an Allergist. Subsequently under went skin testing that demonstrated positive reactions to trees, grass and weeds, but did not address vaccine allergies and or desensitization.
Age: 34.0
Sex: F
Vaccine: FLU3, HEPA, TD
Symptoms: Throat tightness, Tongue oedema, Urticaria
Clinical narrative: See attached clinical summary. Reports being in good health with no prior adverse reactions to any previous immunization until November 2, 2002. She received 3 immunizations and a PPD (Hepatitis A #2, Influenza and Td) the morning of November 2nd, without apparent incident. States that approximately 30 minutes later recalls, a tingling feeling, a slight itchy in the throat and feeling tired, so went to lie down. Later that afternoon, @2:30PM noted itchiness on arms and neck followed by a generalized rash with hives and welts on the neck arms, chest and back. Also had swelling of the face and hands. Denies wheezing, fever, nausea or vomiting, but says tongue felt swollen and throat felt tight and felt woozy. Was seen in the clinic and immediately sent to the ER. Once there was given Benadryl 50mg IM, received IV fluids, O2, and observed until the symptoms began to subside. Was released on oral prednisone and given a referral to be evaluated by an Allergist. Subsequently under went skin testing that demonstrated positive reactions to trees, grass and weeds, but did not address vaccine allergies and or desensitization.
Age: 5.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site reaction
Clinical narrative: Local reaction greater than normal
Age: 4.0
Sex: M
Vaccine: DTAP
Symptoms: Pruritus, Rash erythematous, Swelling, Urticaria
Clinical narrative: Within 15 min after injection, Pt broke out in hives all over body. Referred to PMD or ER. Seen at Medical ctr. with itching, red rash, swollen Right wrist due to hives. Tx'd with Benadryl 12.5 mg po, continue as needed through night.
Age: 28.0
Sex: M
Vaccine: HEPA, IPV, TD
Symptoms: Headache, Pyrexia, Stomach discomfort
Clinical narrative: Generalized Headache, Low grade fever, upset stomach
Age: 2.0
Sex: F
Vaccine: HEPA
Symptoms: Rash
Clinical narrative: Patient came in for her 2 y.o. physical on 4/27/04 11AM then received Hep A vaccine at 11:30AM then came back in at 1PM for 1:30PM appt with Dr. It was reaction to the Hep A vaccine received Benadryl liquid then rashes disappeared at 1:40 PM. According to pt's mother she stated that rashes reappeared last night and this morning again. Pt. on Benadryl will stay on for 4-5 days.
Age: 7.0
Sex: F
Vaccine: VARCEL
Symptoms: Rash vesicular
Clinical narrative: Varicella rash
Age: 74.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Pt had redness and swelling at injection site. Went to local emergency room for evaluation. Discharged with no treatment necessary. Plans to follow up with own doctor.
Age: 11.0
Sex: F
Vaccine: TD
Symptoms: Agitation, Crying, Erythema, Hypokinesia, Neck pain
Clinical narrative: Received Td vaccine, woke up that night crying, temp of 102, shaking- mom gave Motrin-then 10m later c/o neck hurting and not being able to move her legs-taken to ER-mom states given IV fluids, EKG, and labs normal, urine, neg.- follow up visit with pediatrician showed erythematous circular lesion on left deltoid. Otherwise unremarkable.
Age: 11.0
Sex: F
Vaccine: TD
Symptoms: Pyrexia, Tremor
Clinical narrative: Received Td vaccine, woke up that night crying, temp of 102, shaking- mom gave Motrin-then 10m later c/o neck hurting and not being able to move her legs-taken to ER-mom states given IV fluids, EKG, and labs normal, urine, neg.- follow up visit with pediatrician showed erythematous circular lesion on left deltoid. Otherwise unremarkable.
Age: 2.0
Sex: F
Vaccine: DTAP, HEP, HIBV, IPV
Symptoms: Erythema, Injection site induration, Pruritus
Clinical narrative: 4/29/04 TC from mother-area on right leg with erythema approx. 5-7cm in diameter with hard central area, no fever, area not warm to touch- call if persists recommended wm compress; Benadryl for itching
Age: 4.0
Sex: M
Vaccine: UNK
Symptoms: Agitation, Crying, Pruritus, Rash
Clinical narrative: Pt was hysterical at time of vac. administered. Did not calm down after 20 min. Mom left with child. Gave Motrin, child fell asleep, woke up shortly after itching head and blotchy rash over trunk and extremities. Returned to office for evaluation.
Sex: M
Vaccine: DTAP, IPV
Symptoms: Erythema, Feeling hot, Injection site reaction, Swelling
Clinical narrative: Large local reaction 12cmx10cm, red, hot, swollen. Good patient movement.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema
Clinical narrative: Erythema on Left shoulder 9x12cms
Age: 14.0
Sex: M
Vaccine: HEP, OPV, TYP
Symptoms: Pruritus, Rash
Clinical narrative: 2 large wheals on both upper arms in deltoid areas of both right and left arms- Approx. 10:30AM. At 5:30 PM developed large wheal right cheek, both thighs. Extremely itchy-treated with Benadryl and ice. Following day 4/13/04 Rash subsided, skin however still itchy. By 4/14/02 no more symptoms
Age: 1.0
Sex: F
Vaccine: DTAPHEPBIP, HIBV, MMR, PNC, VARCEL
Symptoms: Rash erythematous
Clinical narrative: Per mother after receiving injection , she picked up rx from pharmacy, went to car notice red rash approx. 15 mins after receiving injection. Mother left clinic and went home. returning later to urgent care center.
Age: 1.58
Sex: F
Vaccine: IPV, VARCEL
Symptoms: Drug ineffective, Infection, Pyrexia
Clinical narrative: 5 pox, cold signs, low grade fever for 2 days.
Sex: M
Vaccine: DTAP, MMR
Symptoms: Erythema, Feeling hot, Oedema
Clinical narrative: Swollen, hot, red arm in right deltoid area.
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Blister, Erythema, Injection site erythema, Injection site oedema, Injection site warmth
Clinical narrative: Site at injection was red, swollen hot to touch. No discharge seen in office on 2nd day area 16 1/2 cm x 10 cm and erythema with edges of small vesicles.
Age: 9.0
Sex: M
Vaccine: DTAP, VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Received varivax 02-27-97. Diagnosed with Varicella 4-30-04.
Age: 48.0
Sex: F
Vaccine: PPV
Symptoms: Discomfort, Erythema, Injection site erythema, Myalgia, Nausea
Clinical narrative: Pneumovax administered right deltoid Apr 27 (site) soreness noted that evening- fever that night nausea 2 days with increased area right upper arm discomfort, pt noted April 29 erythema at immunization site, extending distally o/e right upper arm- irregular (poorly detoured borders) erythema, callor, tenderness, induration- 6 x 2cm area no axillary lymphad.
Age: 48.0
Sex: F
Vaccine: PPV
Symptoms: Skin nodule, Tenderness
Clinical narrative: Pneumovax administered right deltoid Apr 27 (site) soreness noted that evening- fever that night nausea 2 days with increased area right upper arm discomfort, pt noted April 29 erythema at immunization site, extending distally o/e right upper arm- irregular (poorly detoured borders) erythema, callor, tenderness, induration- 6 x 2cm area no axillary lymphad.
Age: 74.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Oedema, Pain
Clinical narrative: Redness, swelling, pain.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Oedema
Clinical narrative: Parents noted right thigh to be red, warm, swollen in an area of 5 x 7 cm. Child treated with Ibuprofen, ice to area. No clinic visit required.
Age: 0.42
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PPV
Symptoms: Skin nodule
Clinical narrative: 5 month old presented to urgent visit center with mass in left anterior thigh. Received Pediarix, Pedvax, Prevnar on 4/22/04.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Oedema, Tenderness
Clinical narrative: Left arm red, warm to touch, sl. tender, swollen about 8-10 cm.
Age: 10.0
Sex: M
Vaccine: VARCEL
Symptoms: Blister, Erythema, Skin nodule
Clinical narrative: 1 week after varicella vaccine developed vertical 9 cm x 8 cm horizontal erythema inside of which are two areas of induration 2 x 2 cm on top 1.2 cm x 2.4 cm lower. Lowest one has 2 vesicles at 4 o'clock.
Age: 1.0
Sex: M
Vaccine: MMR
Symptoms: Nasal congestion, Rash morbilliform
Clinical narrative: morbiliforme rash on the body, corisa, congestion, no lymphadenopthy.
Age: 1.25
Sex: F
Vaccine: MMR
Symptoms: Rash morbilliform
Clinical narrative: Mobiliforme rash on trunk.
Age: 0.75
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Pyrexia
Clinical narrative: Temp up to 102 on day following vaccine admin. Exam negative. Strep quick test negative. No prescription given with Tylenol for fever.
Age: 2.0
Sex: F
Vaccine: HBHEPB, VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Received Varicella vaccine on 11/19/2002. Presented on 4/29/04 with varicella in office. Still erupted.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Oedema
Clinical narrative: Redness & swelling in arm from shoulder to elbow.
Age: 0.5
Sex: F
Vaccine: DTAPHEPBIP, HIBV
Symptoms: Rash papular, Rash pruritic
Clinical narrative: Rash on both thighs- pruritic with papular rash. Following 6 month shot no fever same rash appeared for 2 weeks after 4 month shots also per mom did not seek doctor advice on those not documented in our office.
Age: 1.5
Sex: F
Vaccine: DTAP, HIBV
Symptoms: Erythema, Feeling hot, Injection site induration, Oedema, Skin nodule
Clinical narrative: 2 days after receiving DTaP and Hib, noted right thigh swelling (the "size of an orange"), redness, warmth. Seen in office next day. Symptoms better but still with induration around both immunization sites. Since otherwise asymptomatic observed. No treatment.
Age: 0.5
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Pyrexia, Urticaria
Clinical narrative: Urticarial rash began day of immunization approx. 8 hours following immunizations fever began day following immunization. Treated with Benadryl.
Age: 76.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Oedema
Clinical narrative: Red, swollen left deltoid area after immunization.
Age: 37.0
Sex: M
Vaccine: ANTH, TYP
Symptoms: Rash
Clinical narrative: Pt noticed a rash on right forearm beginning approx. 14 hours after injection right deltoid region.
Age: 0.5
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Abnormal behaviour, Crying, Decreased appetite, Irritability, Pyrexia
Clinical narrative: Mother reports decreased interest in solid foods, actually refusing solids and only drinking from botle, + no longer babbling, since 6 mo immunizations. Had been fussier more than normal, crying for 2-3 hours after vaccines with an elevated temp (102-103)  within 24 hours of administration.
Age: 0.5
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Rash
Clinical narrative: 2-24-04: Four month shots led to significant rash. Patient taken to clinic and treated with Benadryl.
Sex: M
Vaccine: DTAP, IPV
Symptoms: Feeling hot, Injection site erythema, Injection site induration
Clinical narrative: Positive erythema at site with induration and warmth 50mmx40mm diameter. No lymphodenopath. Pt treated with Keflex.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: 1.5cm reddness at both sites swelling at DTaP. Otherwise feels fine.
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR, PNC, VARCEL
Symptoms: Injection site swelling
Clinical narrative: Right arm swelling at localized site.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Swelling, Tenderness
Clinical narrative: Mom mentioned at a sick visit 4/27/04 that the day after the pt received her 4 yr vaccines. DTaP, MMR, IV that her left upper arm including shoulder were red, swollen, tender and warm. It resolved after one week with no treatment. At 4/27/04 the left arm was completely normal.
Age: 54.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Feeling hot, Tenderness
Clinical narrative: Left deltoid erythematous, warm, tenderness . 8.5cmx11.5cm.
Age: 15.0
Sex: F
Vaccine: HEP
Symptoms: Folliculitis, Rash vesicular
Clinical narrative: Rash, probably herpes zooster 2 days post Hep B. Questionalbe folluculitis.
Age: 2.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Drug ineffective, Rash vesicular, Viral infection
Clinical narrative: Cutaneous varicella. Dew drop rose petal.
Age: 0.3
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Convulsion, Lethargy
Clinical narrative: Brief seizure-5-7 second with subsequent sleep x 1 hour and some lethargy x 1-2 hours. No sequelae observed on exam 5-3.
Age: 13.0
Sex: F
Vaccine: UNK
Symptoms: Urticaria
Clinical narrative: 3 days after Hep B vaccine #2. Pt began developing hives; treated x 2 at medical center ER
Age: 44.0
Sex: F
Vaccine: TD
Symptoms: Hypokinesia, Lethargy, Pain, Tenderness
Clinical narrative: 4/30 Felt aches (severe) was bed ridden for 2 days, 5/1 +5/2. Monday, May 3 still sore. Right underarm severe pain and couldn't move legs. It was an inner ache and now an outer ache. Right side more. I can't say fatigue. Just couldn't move.
Sex: U
Vaccine: DTAP, MMR, VARCEL
Symptoms: Eye swelling, Swelling
Clinical narrative: Pt seen in ER for swelling of right arm and swelling right eye. Treated by ER with steroids.
Age: 1.3
Sex: M
Vaccine: DTAP, HIBV, MMR, PNC
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: Received DTaP in deltoid IM on right arm and MMR SQ in posterior right arm. Developed erythema, increased skin warmth and moderate swelling over deltoid region of right arm around 5cm starting on 5/1/04. No temperature or irritability. Does not extend to site of MMR vaccination.
Age: 35.0
Sex: F
Vaccine: HEPAB, TD, TYP, YF
Symptoms: Fatigue, Nausea
Clinical narrative: Received phone call from pt. Complained of fatigue and nausea since receiving shot on 4/15/04
Age: 3.0
Sex: M
Vaccine: VARCEL
Symptoms: Infection
Clinical narrative: Patient developed varicella infection.
Age: 21.0
Sex: M
Vaccine: TD
Symptoms: Cellulitis, Injection site reaction
Clinical narrative: Cellulitis - at injection site - 2 days post-immunization. Keflex 500mg. tid X 7 days
Age: 30.0
Sex: F
Vaccine: DT
Symptoms: Injection site induration, Injection site pain, Injection site reaction
Clinical narrative: Very large, indurated, painful local reaction. Sized 3cm X 5cm.
Age: 27.0
Sex: F
Vaccine: HEP, HEPA
Symptoms: Arthralgia, Feeling hot, Gout, Headache, Nausea
Clinical narrative: 4/13/04 sudden onset of Right ankle pain, woke with the pain. came to clinic for eval.  noted some slight swelling, some slight increased warmth,  Discomfort not relieved by ice, warmth or elevation.  Right lateral ankle was very painful to palpatation.  Given toradol and sent to ER.  ER physician  reporedly gave her anti inflammatory drugs and told her she had gout. Had started birth control pills within past 2 weeks. Nausea and vomiting and bad headache also.   episode lasted about 5 days
Age: 27.0
Sex: F
Vaccine: HEP, HEPA
Symptoms: Oedema, Vomiting
Clinical narrative: 4/13/04 sudden onset of Right ankle pain, woke with the pain. came to clinic for eval.  noted some slight swelling, some slight increased warmth,  Discomfort not relieved by ice, warmth or elevation.  Right lateral ankle was very painful to palpatation.  Given toradol and sent to ER.  ER physician  reporedly gave her anti inflammatory drugs and told her she had gout. Had started birth control pills within past 2 weeks. Nausea and vomiting and bad headache also.   episode lasted about 5 days
Age: 24.0
Sex: F
Vaccine: SMALL
Symptoms: Erythema multiforme, Pruritus, Rash
Clinical narrative: Patient developed rash consistent with Erythema Multiforme. Pt given Atarax for pruritis and monitored.
Age: 0.8
Sex: M
Vaccine: DTAP
Symptoms: Abnormal behaviour, Agitation, Balance disorder, Irritability, Livedo reticularis
Clinical narrative: Fever  103.5 for 5 days; Twitching body movements while laying still day 6 and 7 post vaccine; Skin Mottling day 6, 7,and 8 post vaccine; Crossed Left Eye day 6, 7, 8 and 9 post vaccine; Unconsolable crying fits at night with arching of back from day 6 post vaccine and continuing; Poor nursing with arching of back and crying form day 6 post vaccine and continuing; Loss of balance day 6, 7, 8 and 9 post vaccine; Changes in emotion behavior and irritability from day 6 post vaccine and continuing.  All signs and symptoms as reported by the mother.
Age: 0.8
Sex: M
Vaccine: DTAP
Symptoms: Muscle twitching, Opisthotonus, Oral intake reduced, Pyrexia, Strabismus
Clinical narrative: Fever  103.5 for 5 days; Twitching body movements while laying still day 6 and 7 post vaccine; Skin Mottling day 6, 7,and 8 post vaccine; Crossed Left Eye day 6, 7, 8 and 9 post vaccine; Unconsolable crying fits at night with arching of back from day 6 post vaccine and continuing; Poor nursing with arching of back and crying form day 6 post vaccine and continuing; Loss of balance day 6, 7, 8 and 9 post vaccine; Changes in emotion behavior and irritability from day 6 post vaccine and continuing.  All signs and symptoms as reported by the mother.
Age: 3.0
Sex: F
Vaccine: MMR
Symptoms: Anxiety, Asthenia, Chest discomfort, Dry mouth, Dyspnoea
Clinical narrative: Prior to receiving the shot, client was very anxious about getting the shot, given her prior reaction to a tetanus shot.Within 10 minutes of receiving vaccine, client began to feel weak in the knees, had tightness of chest, a perceived difficulty breathing, a feeling of heat inside her ears, thick tongue, dry mouth.  She was observed and offered cold water and an ice pack.  Within 10 muniutes of this, client requested that she be taekn to ER.  There she was monitored and given benedryl and pepscid.  She was subsequently discharged with a diagnosis of possible mild allergic reaction to vaccine.
Age: 3.0
Sex: F
Vaccine: MMR
Symptoms: Ear disorder, Hypersensitivity, Similar reaction on previous exposure to drug, Tongue disorder
Clinical narrative: Prior to receiving the shot, client was very anxious about getting the shot, given her prior reaction to a tetanus shot.Within 10 minutes of receiving vaccine, client began to feel weak in the knees, had tightness of chest, a perceived difficulty breathing, a feeling of heat inside her ears, thick tongue, dry mouth.  She was observed and offered cold water and an ice pack.  Within 10 muniutes of this, client requested that she be taekn to ER.  There she was monitored and given benedryl and pepscid.  She was subsequently discharged with a diagnosis of possible mild allergic reaction to vaccine.
Age: 0.8
Sex: M
Vaccine: HEP
Symptoms: Decreased appetite, Erythema multiforme, Oedema, Rash, Skin discolouration
Clinical narrative: One day following administration of the Hepatitis B vaccine, the patient developed 1-4cm hives all over his body.  Over the subsequent two days, the rash turned into erythema multiforme target lesions and he developed swollen wrists and ankles.  His CBC at the time was unremarkable.  At this point the child was given decadron im which resulted in an 18 hour resolution of the rash.  He was continued on prednisolone.  Prior to administration of the vaccine, the mother reports his appetite was slightly off but no other symptoms.  He has not had fever, runny nose, vomiting, diarrhea.  His mother now reports that he has a slightly unusual coloration of his skin for which he will be evaluated tomorrow.
Age: 0.8
Sex: M
Vaccine: HEP
Symptoms: Skin ulcer, Urticaria
Clinical narrative: One day following administration of the Hepatitis B vaccine, the patient developed 1-4cm hives all over his body.  Over the subsequent two days, the rash turned into erythema multiforme target lesions and he developed swollen wrists and ankles.  His CBC at the time was unremarkable.  At this point the child was given decadron im which resulted in an 18 hour resolution of the rash.  He was continued on prednisolone.  Prior to administration of the vaccine, the mother reports his appetite was slightly off but no other symptoms.  He has not had fever, runny nose, vomiting, diarrhea.  His mother now reports that he has a slightly unusual coloration of his skin for which he will be evaluated tomorrow.
Age: 10.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Asthenia, Difficulty in walking, Disturbance in attention, Dizziness, Dyspnoea
Clinical narrative: on 11/30/01 patient had an episode of vestibular neuronitis requiring an er visit--he has had chronic fatigue since
Age: 10.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Fatigue, Malaise, Neuritis, Vestibular disorder, Vomiting
Clinical narrative: on 11/30/01 patient had an episode of vestibular neuronitis requiring an er visit--he has had chronic fatigue since
Age: 10.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Fatigue, Neuritis
Clinical narrative: on 11/30/01 patient had an episode of vestibular neuronitis requiring an er visit--he has had chronic fatigue since
Age: 31.0
Sex: U
Vaccine: ANTH
Symptoms: Pain, Skin burning sensation, Thermal burn
Clinical narrative: Pt describes - burn at injection site about 1 minute after then back began to tighten by 20 minutes post injection pain 8/10 and worse with deep breath also initial burning into left arm to finger tips.
Age: 18.0
Sex: F
Vaccine: MMR
Symptoms: Pruritus, Rash, Rash macular
Clinical narrative: 4/24/04  0035 Reports skin rash and itching. No respiratory involvement. Sent to ER. Prednisone 40mg daily x 5 days. 4-28-04 noted big blotchy rash seen by MD. Solu-corter 100 mg IM given. Tricortison 0.1010 cream, Zyrtec 10mg qd. 4/30/04 came back.
Age: 1.25
Sex: M
Vaccine: DTAP, VARCEL
Symptoms: Difficulty in walking, Erythema, Swelling
Clinical narrative: Left medial and high swelling with slight erythema to twice the size of opposite leg. Pt presented to clinic 2 days after. Administration of vaccinations. No fever. Pt refusing to walk.
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Feeling hot, Injection site induration, Pyrexia, Swelling
Clinical narrative: Left arm mildly warm this AM. While at school increased redness, swelling and fever. Left shoulder erythema and induration 11.5cm x 9cm.
Age: 2.0
Sex: M
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site swelling, Pyrexia, Vomiting
Clinical narrative: redness and swelling at injection site, fever and vomiting
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site pain, Injection site reaction
Clinical narrative: Three vaccines placed in arm with erythema/induration/ pain starting the following day. By 48hours pt had cellulitis.
Age: 19.0
Sex: F
Vaccine: DTAP
Symptoms: Oedema
Clinical narrative: bilateral sitting edema
Age: 5.0
Sex: M
Vaccine: DTAP, MMR
Symptoms: Injection site erythema, Injection site induration, Injection site pain
Clinical narrative: 1. Erythema and induration at injection site and extending beyond 3cmx7cm - right upper arm. 2. Pain at injection site (deltoid area rt arm)
Age: 1.9
Sex: M
Vaccine: DTAP, IPV
Symptoms: Injection site induration, Urticaria
Clinical narrative: Pt was given DTaP injection left thigh IM. Immediate golf size lump appeared and a welt hive appeared. Pt was to have Tylenol and Benadryl and cold compress.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Oedema
Clinical narrative: mother stated arm had small red area evening of 5/4/04 but by evening of 5/5/04 l arm was swollen & red from shoulder to elbow
Age: 76.0
Sex: F
Vaccine: PPV
Symptoms: Feeling hot, Oedema, Pain, Pruritus, Rash erythematous
Clinical narrative: Left arm swollen, hot red, sore, an area of 6"x8" was itchy,raised about 1/2 inch.
Age: 35.0
Sex: F
Vaccine: MMR, MMR
Symptoms: Laboratory test abnormal, Pain, Pruritus, Rash
Clinical narrative: MMR GIVEN 4/19/04 @ 1:30P 4/29/04 DEVELOPED BODY ACHE, ITCH...SX CONTINUED THROUGH 5/1/04. 5/1/04...RASH BEGINS (STATES ONE PAPULE) 5/2/04...RASH PROGRESSES (ABOUT 10) 5/3/04...MORE DIFFUSE...ITCHING PERSISTS...SEEKS MEDICAL TREATMENT IN ER (BENADRYL PRESCRIBED FOR RELIEF OF SX) 5/6/04 REPORTS FLARING OF RASH AND ITCHING 4-6 HOURS AFTER BENADRYL...ADVISED TO SEEK MEDICAL ATTENTION FROM PMD OR RETURN TO CLINIC.
Age: 35.0
Sex: F
Vaccine: MMR, MMR
Symptoms: Pain, Pruritus, Rash
Clinical narrative: MMR GIVEN 4/19/04 @ 1:30P 4/29/04 DEVELOPED BODY ACHE, ITCH...SX CONTINUED THROUGH 5/1/04. 5/1/04...RASH BEGINS (STATES ONE PAPULE) 5/2/04...RASH PROGRESSES (ABOUT 10) 5/3/04...MORE DIFFUSE...ITCHING PERSISTS...SEEKS MEDICAL TREATMENT IN ER (BENADRYL PRESCRIBED FOR RELIEF OF SX) 5/6/04 REPORTS FLARING OF RASH AND ITCHING 4-6 HOURS AFTER BENADRYL...ADVISED TO SEEK MEDICAL ATTENTION FROM PMD OR RETURN TO CLINIC.
Age: 0.2
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Pyrexia, White blood cell count increased
Clinical narrative: Mom returned to clinic 1 day post vaccination reporting child had developed a fever ranging from 103 to 105.  Not excessivily fussy, no high pitched cry, normal appetite. Tylenol at 6:30 am, temp in clinic 2 hours later was 100.9.  Blood test revealed an elevated white count.
Age: 0.0
Sex: F
Vaccine: TTOX
Symptoms: Dizziness, Ear disorder, Fatigue, Influenza like illness, Lymphadenopathy
Clinical narrative: This I wrote on a message board 2/24/04  Got my shot yesterday. Not sure if it was just Tenus or TD - I will find out tomorrow. Arm is killing me despite the fact I iced it all night. Fever I took tylenol last night, this morning and at work ran out for Aleve. Light headed dizzy flu feeling. I have MS and Diabetes 2. I hope my Dr didn't give me the TD but I think he did. 10 years ago this didn't happen to me. BTW I have been on Zithromax 5 days for bronchittis which is better, and my lungs were clear yesterday. I blame the shot.    POSTED 3/17/04 Well I had my shot on 2/23 this is a followup. The nurse said it was just tetnus, however I got the bill today and it was coded as TD. I have been sick ever since, muscle aches, pnemonia, sore throat, swollen glands, now my ear and throat again. 10 years agfo I was fine. Having MS and Diabites the Dr should have known as the flu shot does this to me as well. Hoping to feel better soon. fatigued and drained   5/6/04 - I was sick for well over a month.
Age: 0.0
Sex: F
Vaccine: TTOX
Symptoms: Myalgia, Pain, Pharyngolaryngeal pain, Pneumonia, Pyrexia
Clinical narrative: This I wrote on a message board 2/24/04  Got my shot yesterday. Not sure if it was just Tenus or TD - I will find out tomorrow. Arm is killing me despite the fact I iced it all night. Fever I took tylenol last night, this morning and at work ran out for Aleve. Light headed dizzy flu feeling. I have MS and Diabetes 2. I hope my Dr didn't give me the TD but I think he did. 10 years ago this didn't happen to me. BTW I have been on Zithromax 5 days for bronchittis which is better, and my lungs were clear yesterday. I blame the shot.    POSTED 3/17/04 Well I had my shot on 2/23 this is a followup. The nurse said it was just tetnus, however I got the bill today and it was coded as TD. I have been sick ever since, muscle aches, pnemonia, sore throat, swollen glands, now my ear and throat again. 10 years agfo I was fine. Having MS and Diabites the Dr should have known as the flu shot does this to me as well. Hoping to feel better soon. fatigued and drained   5/6/04 - I was sick for well over a month.
Sex: F
Vaccine: OPV
Symptoms: Brain neoplasm, Brain neoplasm malignant
Clinical narrative: Information regarding poliovirus vaccine (manufacturer unknown) was received from an attorney regarding a female patient who experienced malignant brain tumor. The patient received vaccine. Medical History: Relevant medical history was not provided. Product Details: Indication for poliovirus vaccine was immunization. Product was administered "during the 1960's." dose regiment was not provided. Concomitant therapy: Concomitant medications were not reported. Event Details: The attorney alleges that the polio vaccine received by the decedent contained a harmful prohibited animal virus known as Simian Virus 40 (SV 40). The Simian Virus 40 contained within the polio vaccine product was the cause of the malignant brain tumor (brain neoplasm malignant) that caused the death of the decendent. The decendent died on 03-Dec-2001. No additional information was available at the time of this report.
Age: 1.5
Sex: F
Vaccine: DTAP, HIBV, IPV
Symptoms: Cough, Hypersensitivity, Stridor, Wheezing
Clinical narrative: Sudden onset of wheezing and stridors cough. Nurse follow up on 09/14/04 states: "Allergic reaction."
Age: 32.0
Sex: M
Vaccine: ANTH
Symptoms: Erythema, Urticaria
Clinical narrative: -diffuse hives and erythema (arm, neck, head) - no airway/breathing problems - relieved by Benadryl
Age: 27.0
Sex: F
Vaccine: ANTH
Symptoms: Erythema, Fatigue, Flushing, Nausea, Oedema
Clinical narrative: 03APR04- right arm 10:30- felt nauseous, flushed, tired, maybe slight fever. 04APR04 local edema, erythema, 800 mg Advil taken. Still tired.
Age: 27.0
Sex: F
Vaccine: ANTH
Symptoms: Pyrexia
Clinical narrative: 03APR04- right arm 10:30- felt nauseous, flushed, tired, maybe slight fever. 04APR04 local edema, erythema, 800 mg Advil taken. Still tired.
Age: 49.0
Sex: F
Vaccine: ANTH
Symptoms: Breast tenderness, Joint range of motion decreased, Nausea, Pyrexia
Clinical narrative: Left arm into left chest wall tender to touch. Difficulty lifting arm. Fever, Nausea 4/4/04. AM
Age: 6.0
Sex: F
Vaccine: DTAP, HEP, HEPA, IPV, MMR
Symptoms: Feeling hot, Pruritus, Swelling, Tenderness
Clinical narrative: Right arm swollen, hot from shoulder to elbow. Mother states child complained of soreness and itching.
Age: 1.9
Sex: F
Vaccine: DTAP, HBHEPB
Symptoms: Injection site warmth, Swelling
Clinical narrative: 4/12/2004-LUT swelling noted last night. Hot to touch at site of injection. No raise in temp. 4/13/04 -phone call to mom. Clients leg looks much better today. Swelling down. No longer hot to touch. 4/22/04 follow up with mom. No further problems and lump gone.
Age: 1.2
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Listless, Pyrexia, Rash maculo-papular, Sleep disorder
Clinical narrative: 6 days of fever 103-104 range. Started day 5 after vaccines. Rash-MP type- suggestive of measles. Listless, slept 20hr/day. Recovered about 4/23/04.
Age: 0.3
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Pyrexia, Rash, Rash maculo-papular, Urticaria
Clinical narrative: Purple welt rash  on legs 2 days - 5 days after vaccine, low grade fever about 100-101 degrees F 5-7 days after vaccine. Macular/papular rash 1 week after vaccine.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Injection site pain, Pruritus, Swelling
Clinical narrative: Complained of pain at injection site ; left deltoid where she got her DTaP that day. Woke up with redness, swelling, itching and pain in the area. Seen in office to eval.
Age: 43.0
Sex: F
Vaccine: HEPAB
Symptoms: Blister, Blood pressure decreased, Dyspnoea, Eye swelling, Oedema peripheral
Clinical narrative: Twinrix received 3/17/04 in afternoon. A rxn appeared about midnight of same day. She returned 4:30 PM 3/18/04 to report reaction: swollen knuckles (still visible now), swollen eyelids, blisters on hands, difficulty breathing (lung involvement ; not windpipe). Later her BP dropped "30 units." She almost went to ER , but didn't go. Ate chocolates on 3/17/2004.
Age: 43.0
Sex: F
Vaccine: HEPAB
Symptoms: Swelling
Clinical narrative: Twinrix received 3/17/04 in afternoon. A rxn appeared about midnight of same day. She returned 4:30 PM 3/18/04 to report reaction: swollen knuckles (still visible now), swollen eyelids, blisters on hands, difficulty breathing (lung involvement ; not windpipe). Later her BP dropped "30 units." She almost went to ER , but didn't go. Ate chocolates on 3/17/2004.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Pruritus, Swelling
Clinical narrative: redness, swelling and pruritis
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Oedema, Pruritus
Clinical narrative: erythema, edema and pruritus of right deltoid region
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site rash, Injection site swelling, Rash maculo-papular
Clinical narrative: 4-29: grandmother noticed red swollen area on right leg (area of DTaP inj). 4-30: brought to clinic, has large 3"x4" "splotchy" type rash on right upper leg in the area of the DTaP injection. Not warm to the touch, not swollen. Grandmother says it is better today after taking benadryl. Taking him to Dr.
Age: 0.3
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Agitation, Irritability
Clinical narrative: Irritability and difficult to console for 48hrs after vaccines at 4 month well visit.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Coma, Fall, Pallor, Tremor
Clinical narrative: Mother reported to ER that at 2:00 PM she removed band aid on arm where pt. received shots at 9:00 PM and pt immediately became pale and fell down and arms were shaking. Pt was unresponsive  1-2minutes.
Age: 1.5
Sex: M
Vaccine: DTAP
Symptoms: Erythema, Swelling
Clinical narrative: Redness and swelling in left delotoid 50x50mm. Advised to use cool compresses and tylenol.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Pyrexia, Swelling
Clinical narrative: 1) fever up to 100.0 degrees mother states 2) red swollen area warm to touch on RUA about 5x5 and 1/2 cm in size.
Age: 7.0
Sex: M
Vaccine: VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Chicken pox developed after having varivax
Age: 1.0
Sex: F
Vaccine: DTAP, VARCEL
Symptoms: Erythema, Pain, Swelling
Clinical narrative: Rt thigh swollen, red, painful x2D
Age: 8.0
Sex: M
Vaccine: VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: This 8 yo child developed varicella on 04/29/04 after having had the vaccine 10/05/96
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site nodule
Clinical narrative: Client has pea-sized nodule, rt upper forearm, which mother claims is from vaccine received in Aug 2003. However nodule is not a typical injection site
Age: 8.0
Sex: M
Vaccine: VARCEL
Symptoms: Infection
Clinical narrative: Diagnosed 4/30/04 with attenvated varicella
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site induration, Skin hyperpigmentation
Clinical narrative: Slight induration with overlying hyperpigmentation. No treatment necessary
Age: 8.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Unevaluable event
Clinical narrative: No adverse event described.
Age: 3.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Diagnosed 4/27/04 with attenvated varicella
Age: 3.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Aphasia, Asthenia, Balance disorder, Drooling, Dysphagia
Clinical narrative: pt's illness manifests itself in a variety of ways. The most common of these are debilitating body weakness, head tilting (torticollis) and balance issues. Early on these episodes were very sporadic in nature and would happen once every several weeks. They came on only when he was tired and were alleviated by sleep. As the illness progressed, so did the frequency and duration of the episodes. By May and June, they became an almost daily occurrence and would come on at all times of the day not just when pt was fatigued. Since January of 2003, we've seen little if any progress in pt's gross and fine motor development. In addition, pt demonstrates cognitive impairment with significant delays in both receptive and expressive language.  Episodic Symptoms: 1. General body weakness (hypotonia), 2. Head tilts (torticollis), 3. Compromised use of arms and hands, 4. Balance problems, 5. Drooling, 6. Difficulty chewing and swallowing, 7. Ptosis (droopy eyes), 8. Crossing of eyes, 9. Extreme fussiness. Not all symptoms present themselves during every episode. Sometimes there is a progression of symptoms (ie eyes off, then head tilt, then body weakness). Symptoms are alleviated, at least temporarily, by sleep. Daily Symptoms: 1. Significant receptive language delays (ie can't ID body parts or play pat-cake), 2. Significant expressive language delays (ie has 1 daily word, down from 12 in Jan), 3. Decreased body strength (ie can no longer crawl up a flight of stairs), 4. Gross Motor delays (ie cannot stand or walk unassisted),5. Balance problems, 6. Low muscle tone, 7. Fatigues easily. Pt at baseline is able to crawl, pull to stand, make steps supported by two hands and cruise along furniture. Since February 2003 pt has received weekly physical and development therapy through and early intervention program.
Age: 3.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Eyelid ptosis, Fatigue, Hypokinesia, Hypotonia, Irritability
Clinical narrative: pt's illness manifests itself in a variety of ways. The most common of these are debilitating body weakness, head tilting (torticollis) and balance issues. Early on these episodes were very sporadic in nature and would happen once every several weeks. They came on only when he was tired and were alleviated by sleep. As the illness progressed, so did the frequency and duration of the episodes. By May and June, they became an almost daily occurrence and would come on at all times of the day not just when pt was fatigued. Since January of 2003, we've seen little if any progress in pt's gross and fine motor development. In addition, pt demonstrates cognitive impairment with significant delays in both receptive and expressive language.  Episodic Symptoms: 1. General body weakness (hypotonia), 2. Head tilts (torticollis), 3. Compromised use of arms and hands, 4. Balance problems, 5. Drooling, 6. Difficulty chewing and swallowing, 7. Ptosis (droopy eyes), 8. Crossing of eyes, 9. Extreme fussiness. Not all symptoms present themselves during every episode. Sometimes there is a progression of symptoms (ie eyes off, then head tilt, then body weakness). Symptoms are alleviated, at least temporarily, by sleep. Daily Symptoms: 1. Significant receptive language delays (ie can't ID body parts or play pat-cake), 2. Significant expressive language delays (ie has 1 daily word, down from 12 in Jan), 3. Decreased body strength (ie can no longer crawl up a flight of stairs), 4. Gross Motor delays (ie cannot stand or walk unassisted),5. Balance problems, 6. Low muscle tone, 7. Fatigues easily. Pt at baseline is able to crawl, pull to stand, make steps supported by two hands and cruise along furniture. Since February 2003 pt has received weekly physical and development therapy through and early intervention program.
Age: 3.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Mental retardation severity unspecified, Strabismus, Torticollis
Clinical narrative: pt's illness manifests itself in a variety of ways. The most common of these are debilitating body weakness, head tilting (torticollis) and balance issues. Early on these episodes were very sporadic in nature and would happen once every several weeks. They came on only when he was tired and were alleviated by sleep. As the illness progressed, so did the frequency and duration of the episodes. By May and June, they became an almost daily occurrence and would come on at all times of the day not just when pt was fatigued. Since January of 2003, we've seen little if any progress in pt's gross and fine motor development. In addition, pt demonstrates cognitive impairment with significant delays in both receptive and expressive language.  Episodic Symptoms: 1. General body weakness (hypotonia), 2. Head tilts (torticollis), 3. Compromised use of arms and hands, 4. Balance problems, 5. Drooling, 6. Difficulty chewing and swallowing, 7. Ptosis (droopy eyes), 8. Crossing of eyes, 9. Extreme fussiness. Not all symptoms present themselves during every episode. Sometimes there is a progression of symptoms (ie eyes off, then head tilt, then body weakness). Symptoms are alleviated, at least temporarily, by sleep. Daily Symptoms: 1. Significant receptive language delays (ie can't ID body parts or play pat-cake), 2. Significant expressive language delays (ie has 1 daily word, down from 12 in Jan), 3. Decreased body strength (ie can no longer crawl up a flight of stairs), 4. Gross Motor delays (ie cannot stand or walk unassisted),5. Balance problems, 6. Low muscle tone, 7. Fatigues easily. Pt at baseline is able to crawl, pull to stand, make steps supported by two hands and cruise along furniture. Since February 2003 pt has received weekly physical and development therapy through and early intervention program.