Age: 65.0
Sex: M
Vaccine: PPV
Symptoms: Local reaction, Musculoskeletal chest pain, Oedema peripheral, Pain in extremity, Pyrexia
Clinical narrative: Information has been received from a registered nurse concerning a 65 year old male patient with no pertinent medical history and no drug reactions or allergies who on 12-OCT-2010, was vaccinated with a dose of PNEUMOVAX 23 (Lot# 667418/0978Z). Concomitant therapy included PRAVACHOL, MOBIC, ZESTRIL, VITAMIN B12, glucosamine, potassium gluconate, ubidecarenone, PREVACID, ATIVAN, SOMA, hydrochlorothiazide, VITAMIN D3, Vitamin D, "garlic", cod liver oil, and omega 3. The registered nurse reported that on 12-OCT-2010, the patient developed an injection site reaction after receiving a dose of PNEUMOVAX 23. Approximately 4 hours later the patient's arm swelled about the size of a football along with severe pain, short of breath, and high temperature of 100.5 degrees. The pain radiated to his left rib cage, and he experienced overall body shivering. The patient was taken to the emergency room and released after receiving an IV antibiotic. At the time of the report, the patient was recovering. Follow up information was received from a registered nurse via medical records. On 13-OCT-2010 at 10:27, the patient's wife stated that on 12-OCT-2010 the patient was given PNEUMOVAX 23 and that the patient had a reaction to the injection. His arm was very painful and swollen, fever and chills, skin turned red and had uncontrollable shaking and had difficulty breathing. The patient went to the ER and was told to see his Primary Care Physician (PCP). On that same day, at 11:28 the patient reported that the vaccine was received about 9:00, reaction started about 13:30 the same day. The patient reported that he developed left upper arm severe pain that radiated to left rib cage, swelling in left upper arm size of a "football", difficulty breathing due to extreme pain and shivering and temperature up to 100.5. On 13-OCT-2010, the patient reported improvement at site of vaccine swelling and redness improving, received IV antibiotics, and received antibiotics prescription tablets to fill at local pharmacy that the patient had not filled as of yet. The patient reported that he would start oral antibiotics as given by ED and will call office on 14-OCT-2010 morning with update to ensure swelling/pain continued improving. The patient reported he continued to be afebrile. On 13-OCT-2010, at 16:20, the patient's wife called and stated her husband was not on antibiotics as he told the nurse and she was very concern as he was told he needed to see his PCP. The patient's wife stated that the patient was not told he had an infection but that it was a local reaction. At 16:48, the registered nurse spoke with the patient's wife who concerned as mis-information provided to office by patient. The patient was not given IV antibiotics or prescribed antibiotics from ED, they were treated that as a local reaction with pain medications and NSAIDs, the patient was advised to follow up with PCP. The patient's wife did confirm the patient was improved when seen at ED but continued to have significant left arm swelling, afebrile, pain in extremity. The next appointment was 15-OCT-2010. No further information is available.