Age: 65.0
Sex: F
Vaccine: PPV, PPV
Symptoms: Tremor, Urticaria
Clinical narrative: Information has been received from a physician concerning a 65 year old female who on 10-DEC-2009 was vaccinated with a 0.5 ml dose of PNEUMOVAX 23 (Lot No. 66487/1142Y). On 11-DEC-2009 the patient developed injection site reaction like arm pain and swelling and rash from injection site straight down to arm after receiving PNEUMOVAX 23. The patient sought unspecified medical attention. A "glucose test" was performed with no results provided. At the time of the report, the outcome of the patient was unknown. Follow up information has been received from a health professional concerning the female patient with no illness at the time of vaccination and allergy to sulfa and COMPAZINE who on 10-DEC-2009 at 11:00 a.m. was vaccinated with a first dose of PNEUMOVAX 23 (Lot No. 66487/1142Y) in her right deltoid. On 11-DEC-2009 the patient sought medical attention at the Emergency Room. On an unspecified date the patient recovered. Follow up information has been received from a physician's assistant from the Emergency Room concerning the female patient with no pertinent medical or surgical history, social history of tobacco use (patient denied tobacco use) and allergy to sulfa drugs and COMPAZINE. There was no concomitant medication. The patient complained of left arm pain and left arm swelling which lasted for 1 day. The type of injury was swelling tenderness. Her degree of pain was minimal and the degree of swelling was moderate. The degree of dysfunction was negative. There were exacerbating factors including movement and palpation. The mitigation factor was negative. The risk factor was PNEUMOVAX 23 prior to onset. There were no prior episodes or prior treatment. Her dominant hand was the right hand. The patient's associated symptoms were negative for constitutional symptoms, stiffness, neurologic injury, bleeding, lymphatic symptoms. Skin symptoms showed "rash". The patient's review of systems was negative for cardiovascular symptoms, respiratory symptoms, gastrointestinal symptoms, coagulopathy. It was noted that the patient was "jittery". The patient's physical examination for general appearance showed "no acute distress". For ears, nose, mouth and throat was "tympanic membranes clear; no pharyngeal erythema or exudate, no swelling". Neck was "supple, no tenderness". Heart was with "regular rate and rhythm". Respiratory exam showed "lungs clear to auscultation bilaterally". Arm exam showed "left upper arm moderate swelling tenderness rash". Range of motion of the arm was "within normal limits". Neurologic and upper extremity exam was "within normal limits". There was no lymphadenopathy. There was also no distal swelling to suggest clot, lymphadenitis, cellulitis, hematoma or abscess. The patient was prescribed BENADRYL 50 mg, IV, soln, when needed for itching; normal saline (bolus), 1.000 mL IV, Soln; and SOLUMEDROL, 125 mg IV, REC. On 11-DEC-2009 the patient's condition was improved and stable. On 11-DEC-2009 the following diagnostic tests were performed: A body temperature measurement was 36.8, site temperature (temporal scan) with no results provided, heart rate was 82, respiratory rate was 16, oxygen (O2) saturation was 95, systolic blood pressure was 145, diastolic blood pressure was 87 and blood sugar was 104. Upon internal review, itching was considered to be an other important medical event. Additional information is not expected.