Age: 70.0
Sex: F
Vaccine: PPV
Symptoms: Alanine aminotransferase increased, Anion gap increased, Aspartate aminotransferase increased, Basophil percentage decreased, Blood albumin normal
Clinical narrative: Initial and follow-up information has been received from a physician concerning a 70 year old female with no known allergies or drug reactions and no illness at the time of vaccination who on 04-NOV-2008 was vaccinated with a dose of PNEUMOVAX 23 (lot no. 660685/0519X) 0.5 ml into the left arm. It was also reported that on 10-OCT-2008 the patient was vaccinated with FLUVIRIN (lot no. 89684) into the left arm. Concomitant medications included, alendronate sodium (MSD), CADUET, aspirin and AMBIEN. The physician reported that on 06-NOV-2008 the patient was seen at the physician's office because had redness, swelling and pain in her left upper arm for two days. The patient had no fever or itching, her temperature was 98. The patient's left arm had erythema. Swelling warmthness, tenderness from mid deltoid to the elbow and there were tender left axillary nodes. The physician's impression was cellulitis and the patient was given ROCEPHIN IM into the office and was prescribed oral antibiotics (unspecified). The physician reported that the patient did not take the oral antibiotics, but instead she went to see another physician who admitted her to the hospital on 07-NOV-2008 for left arm cellulitis. A chest X-ray and X ray of the left arm was performed. The radiology report stated that the views of the left humerus were negative for osseous abnormality, adjacent joint spaces appeared to be intact and no subcutaneous air was identified. No acute lung findings. The physician suggested correlation. Laboratory test performed on 07-NOV-2008 included: anion gap 16 (normal range 5-14), serum glucose test 91 mg/dl (normal range 70 to 110), serum blood urea nitrogen test 16 mg/dl (normal range 7 to 18), serum creatinine test 1.0 mg/dl (normal range 0.7 to 1.2), serum calcium test 10.2 mg/dl (normal range 8.4 to 10.2) total serum protein test 8.2 g/dl normal range (6.3 to 8.2), serum albumin test 4.5 g/dl (normal range 3.9 to 5.0), serum alkaline phosphatase test 92 units/L (normal range 38 to 126), serum aspartate aminotransferase test 65 units/L (normal range 5 to 40), serum alanine aminotransferase test 91units/L (normal range 7 to 56), total serum bilirubin test 0.3 mg/dl (normal range 0.2 to 1.3, serum sodium test 147 mmol/L (normal range 137 to 145), serum chloride test 104 mmol/L (normal range 98 to 107), serum potassium test 3.8 mmol/L (normal range 3.6 to 5.0) total serum carbon dioxide test 27 mmol/L (normal range 22 to 31), blood hemoglobin test 14.3 mmol/L (normal range 11.5 to 15.3) whole blood hematocrit 43.2% (normal range 34 to 45), blood platelet count 263x10e3 (normal range 140 to 400), blood neutrophil count 63.3% (normal range 37-80), blood eosinophilic leukocyte count 2.6% (normal range 0 to 6.0) blood monocyte count 9.8% (normal range 1 to 13), blood basophilic leukocyte count 0.4% (normal range 0-2), blood lymphocyte count 23.8% (normal range 20 to 45), urinalysis test between the normal range, Urine culture which showed no growth and multiple blood culture from different venipuncture sites that showed no growth at 97 hours. The discharge date is 09-NOV-2008. Additional information is not available.