Age: 3.0
Sex: M
Vaccine: DTAPHEPBIP, HIBV, MMR, PNC
Symptoms: Cough, Drooling, Eye movement disorder, Febrile convulsion, Postictal state
Clinical narrative: On Mon, March 27th 2006, I took pt in to his 10:00 Dr's appt. to receive vaccinations. He did not receive his vaccinations until around 11:20 AM. We came home, had lunch, and had out "normal" routine until 2PM, which is nap time. I noticed he didn't seem to be feeling well, but he didn't have a temperature. So, I thought he was just tired from the day and the shots. I put him down for a nap at 2PM. At 5PM, I went in to get him (as usual) and he was lying in bed, eyes wide open, staring at the ceiling and his whole body was shaking. I ran to him and sat him up to see if he was sleeping/dreaming. Then I recalled he'd had his shots that morning. I frantically tried to get him to talk to me-he could not. I scooped him up and ran him downstairs to my husband. My husband tried to get him to talk-he could not talk. We tried to get him to sit up, and he could not sit up on his own. We tried to get him to walk, and he could not walk. He could barely focus on us. My husband rushed him to urgent care within minutes after waking him. At urgent care, the pt seemed very weak, but seemed to be progressively able to talk a little. The doctor took his temperature at that point (about an hour later) and it was 103. They gave him Motrin and soon he seemed to be feeling better and was able to talk, but was extremely weak. The doctor told my husband that he thought the pt had fever tremors. He said just to keep him on IBU. He came home, we all rejoiced that he was better, he had dinner and said he wanted to go to bed. We put him to bed, thinking that the trauma was over. The next day, 3/28, the pt was pretty weak and slow. He didn't have a lot of play energy (which is extremely abnormal for him), but he didn't have a temperature. I was giving him IBU every 6 hours as suggested. So, I though it was, again, just a natural response from the trauma from the day before. I put the pt down at 2PM for nap time (I'd given him IBU at 12:30PM). At 5 pm, my husband got the pt up from his nap. He brought him down and said he was pretty warm. He was HOT. I immediately gave him a TBSP of IBU and put a cool cloth on his neck. I was rubbing his face and neck with the cloth for about 10 min. hoping to help bring the fever down more quickly. I also gave him cool water to drink, but he wasn't very interested in the water or dinner. So, I just kept rubbing him with a cool cloth. When the temperature didn't go down after 30 min. I decided to take his temperature. That's when his whole body stiffened, his eyes rolled back into his head, his mouth opened with drool coming out, and he stopped breathing. I called 911, while my husband got him from his chair and laid him on the floor on his side. About 1 minute into this, he vomited. By the time the EMS got here, he was breathing but he was not alert. His eyes were closed and he was nonresponsive. The paramedics took him from us that way. They worked on him in the ambulance for about 10 minutes, and than I got to see him. His appearance was very familiar. The paramedic working with him called it postictal. He seemed to be experiencing the same symptoms he was on the day before. At the point, we realized that he must have had a seizure the day before as well while he was in bed and by the time we got to him, he was postictal. They took him to ER and they ran some tests. He was having a cough but nothing out of the ordinary with his asthma. They put him on Amoxicillin "just in case". They said it probably wouldn't be helpful because he didn't have any signs of a bacterial infection, but they wanted him on it "just in case". We submitted. They also told us that we could be "aggressive" with the IBU dosage. The told us we could give him 1 1/2 TBSP of IBU every 6 hours. So, we did that when he got home from ER. That night my sister also had told me that her doctor told her that it's OK to stagger IBU and Tylenol. On 3/29, he seemed to be somewhat "normal". I called and updated doctor on how he was doing and to ask her about giving him 1 1/2 TBSP of IBU and staggering Tylenol. She said both would be fine. To be on the "safe" side, that's what we did all day long. He, again, didn't run a fever through the day, but he was weak and was falling a lot-seemed dizzy. I gave him Tylenol right before nap time and checked on him several times during nap time. His temperature did not spike. We thought, once again, that this was "over". Thursday morning we got him from bed to find that his temperature had spiked. His eyes were glassed over as they had been the other times, and he was pretty weak. We were terrified we were about to experience another seizure. We got Tylenol in him immediately and put him in the bathtub with tepid water. His fever did not want to budge. He was in there for about 20 minutes before it seemed safe to get him out. That day, though his fever did not spike again, he was very dizzy. He had to really focus before he started to take steps and would only take about 5 steps before he'd fall, trip or become unbalanced. This seemed to continue though out the day. We took him in for a check-up. He saw a doctor and she said she thought the dizziness was from the seizures. She said he seemed to be doing fine and that he'd recover fully from this. Friday, 3/30, was his and our first "normal" day after a traumatic week of adverse reaction to his immunizations'. Since then, he has seemed to be back to himself. We did take him in for 2nd option and Monday 4/2 and he also seemed to believe he was going to recover fully.  "