chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 0.17
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV1
Symptoms: Surgery, Vomiting
Clinical narrative: STARTED WITH VOMITING AND DIARRHEA ON 11/26/2010.  PRESENTED IN OFFICE ON 11/27/2010 WITH A SOFT, MOBILE SAUSAGE-SHAPED MASS IN LLQ/MID-ABDOMEN.  SENT TO ER FOR EVALUATION.  INTUSSUSCEPTION FOUND AND TRIED TO REDUCE TWICE WITHOUT SUCCESS.  SURGERY DONE TO CORRECT.  ALSO DISCOVERED MALROTATION WHICH REQUIRED SURGERY.
Age: 66.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Injection site cellulitis, Injection site erythema, Injection site pruritus, Injection site swelling
Clinical narrative: The day after vaccination injection site began itching.  By the evening the site was hot with increasing redness and swelling. Patient went to private physician on Friday, 12/10 and was diagnosed with cellulitis.  Treatment with cephalexin 500mg bid for 10 days. 12/13/2010 is improving, arm remains red and swollen.
Age: 66.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site warmth, Oedema peripheral
Clinical narrative: The day after vaccination injection site began itching.  By the evening the site was hot with increasing redness and swelling. Patient went to private physician on Friday, 12/10 and was diagnosed with cellulitis.  Treatment with cephalexin 500mg bid for 10 days. 12/13/2010 is improving, arm remains red and swollen.
Age: 11.0
Sex: M
Vaccine: HEPA, IPV, MEN, MMR, TDAP, VARCEL
Symptoms: Erythema, Infected skin ulcer, Painful respiration, Pruritus, Rash macular
Clinical narrative: PT WAS BROUGHT INTO CLINIC HERE ON 12/3/2010.  VISUALIZED SEVERAL AREAS OF RED SKIN, SOME OPEN SORES, SOME DRY SCABS, SOME PUSSED AREAS.  ITCHING A LOT PER PATIENT.  NOTED BOTH INNER WRISTS, BOTH INNER ELBOWS, CHEST, NECK, EAR (L) VERY RED WITH PUSSED SPOT.  ABDOMEN HAD NUMEROUS RED SPOTS.  STATES NO FEVERS, NO BLISTER AT INJECTION SITE.  NO PROBLEMS BREATHING-JUST NOW TODAY HURT TO BREATHE DEEP.  REFERRED PARENT TO TAKE CHILD TO DR TODAY.  WILL CALL AND REPORT.  THESE ITCHING, SPLOTCHY AREAS STARTED 1 WEEK AFTER SHOTS.
Age: 11.0
Sex: M
Vaccine: HEPA, IPV, MEN, MMR, TDAP, VARCEL
Symptoms: Scab, Skin ulcer, Spleen disorder
Clinical narrative: PT WAS BROUGHT INTO CLINIC HERE ON 12/3/2010.  VISUALIZED SEVERAL AREAS OF RED SKIN, SOME OPEN SORES, SOME DRY SCABS, SOME PUSSED AREAS.  ITCHING A LOT PER PATIENT.  NOTED BOTH INNER WRISTS, BOTH INNER ELBOWS, CHEST, NECK, EAR (L) VERY RED WITH PUSSED SPOT.  ABDOMEN HAD NUMEROUS RED SPOTS.  STATES NO FEVERS, NO BLISTER AT INJECTION SITE.  NO PROBLEMS BREATHING-JUST NOW TODAY HURT TO BREATHE DEEP.  REFERRED PARENT TO TAKE CHILD TO DR TODAY.  WILL CALL AND REPORT.  THESE ITCHING, SPLOTCHY AREAS STARTED 1 WEEK AFTER SHOTS.
Age: 39.0
Sex: M
Vaccine: YF
Symptoms: Type 1 diabetes mellitus, Visual impairment, Weight decreased
Clinical narrative: Service member (SM) was in his usual state of excellent health prior to Aug 2006. He was diagnosed with Type 1 Diabetes Mellitus (T1DM) in Sep 2007. Looking back, SM recalls developing symptoms of hyperglycemia sometime between Aug and Dec 2006. Initially, his symptoms were subtle and he did not feel he was "sick", but his symptoms gradually increased and led to his diagnosis of T1DM in Sep 2007. SM received Yellow Fever vaccine in May 2006 and influenza vaccine in Dec 2006, which receipt of Typhoid vaccine in August 2007, shortly before his diagnosis. He denies any unusual or prolonged reactions within the first week following vaccine receipt. He does not recall any viral-type symptoms just prior to or on the days of vaccine receipt. Symptoms SM reports for months, maybe even a year prior to diagnosis were polyuria, polydipsia, fatigue, and weight loss. He had been losing weight by following the ATKIN's diet for a couple of years prior to symptom onset. His baseline weight in 2006 was about 200 pounds. At the time of diagnosis, his weight was down to about 160 lbs per her Med Records. SM did not experienced changes in sexual function until about 2 months before diagnosis, and he did not experience any visual changes until the week before diagnosis. In Sept 2007, SM was staying in a hotel during his week-end drill. After his wife attempted to call him and did not get an answer, she called the hotel front desk, who called the ambulance. The patient was unconscious and was admitted to hospital between 9/12/2007 and 9/19/2007. He was did not regain consciousness for 3 days and was placed on a ventilator. He believes his serum glucose level was >750 and he was in Diabetic Ketoacidosis (DKA). He suffered from renal insufficiency and almost went on dialysis. During his hospitalization, he developed pneumonia. During his hospitalization, he received hydration and electrolyte replacement, and insulin, as well as diabetes self management training were initiate. He was discharged on once daily LANTUS with additional supplementation for hyperglycemia using HUMALOG. Since diagnosis, SM has been followed through local civilian health care providers. He has been on an insulin pump for about 1 year. Following his diagnosis of T1DM, he had been diagnosed with peripheral neuropathy, ED, skin cancer, hyperlipidemia, right shoulder rotator cuff tear, and left knee ACL tear. Around the time of diagnosis, SM was told he had diabetic changes in left eye, which had later been noted to have resolved at a follow-up exam 2 months later. SM denies a history of elevated glucose or blood pressure levels or history of hypertension prior to T1DM diagnosis. He does not recall a history of a recent infection or symptoms of cough, fever, sinus symptoms, congestion or diarrhea prior to his diagnosis. He was active with sports and met military weight requirements prior to diagnosis. SM has a sister with T1DM who was diagnosed at age 3. (He says he was tested around 1976 to see if the was at risk to develop T1DM and his mother was told he was not at risk.)
Age: 67.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Chills, Injection site pain
Clinical narrative: Chills x 6 hours. Sore arm at site of IM (L) arm.
Age: 50.0
Sex: F
Vaccine: FLU3
Symptoms: Immediate post-injection reaction, Injection site pain, Pain
Clinical narrative: Had Flu shot 11/8/10 in left deltoid - hurt immediately. Gradually got worse over 3 wks - hurts to raise arm. Tender deltoid muscle - no fever or signs of local infection. No hematoma.
Age: 62.0
Sex: F
Vaccine: FLU3
Symptoms: Abdominal pain upper, Body temperature increased, Chills, Headache
Clinical narrative: 11-30-10 9:30 A.M. FLUZONE .5ml IM 12-1-10 3:00 PM Pt. had chills, headache, stomach cramps 12-2-10 10:00 A.M. Temp 101 degrees - but pt. feeling better pt. was told by RPh to take TYLENOL 500mg 2 q 6h prn fever.
Age: 24.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site cellulitis
Clinical narrative: Cellulitis at injection site.
Age: 61.0
Sex: F
Vaccine: FLU3, PPV, TDAP
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia
Clinical narrative: Redness, swelling, warmth 7cm area around influenza vaccine (L) arm fever 102 x 2 days.
Age: 31.0
Sex: F
Vaccine: FLU3, HEPA
Symptoms: Dyskinesia, Immediate post-injection reaction, Syncope
Clinical narrative: Patient fainted within seconds of receiving injection. She was sitting on bench and assisted to lying down position. Slight jerky motion of head and upper extremities. Pt A & O after 5-10 seconds.
Age: 20.0
Sex: F
Vaccine: FLU3
Symptoms: Activities of daily living impaired, Pain, Pain in extremity
Clinical narrative: Arm has been extremely sore from the day I got it. It hurts to lift my arm and do simple tasks like putting clothes on.
Age: 69.0
Sex: F
Vaccine: FLU3
Symptoms: Incorrect dose administered
Clinical narrative: Pt was given High Dose flu vaccine on 12/2/10, when I entered it into Iris I saw that pt was given a regular flu dose on 10/15/10 at our clinic by LPN but was not ordered or entered into Epic in pts chart.
Age: 55.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Injection site rash, Swelling face
Clinical narrative: Swelling of face. No involvement of tongue, mouth or nares.  Rash at injection site. Symptoms present for 48 hours, then gone.
Age: 73.0
Sex: F
Vaccine: FLU3
Symptoms: Asthenia, Dizziness, Feeling cold, Nausea
Clinical narrative: 2 days after receiving flu shot; dizziness, that evening feeling cold & nauseous & weak. The nausea and weakness lasted 3 more days. I rested and ate lightly. Consulted with doctor but did not go to him.
Age: 58.0
Sex: F
Vaccine: FLU3, TDAP
Symptoms: Injection site cellulitis, Injection site erythema, Pain, Pain in extremity, Pyrexia
Clinical narrative: On 10/21/10 (24 hours after vacc), experienced general body aches and low grade fever, relieved w/TYLENOL. On 10/22/10 felt better, afebrile; but c/o "very sore" left arm. 10/25/10 - seen at Urgent Care for (L) arm soreness and erythema at injection site (L) deltoid. Dx cellulitis (L) deltoid. 10/28/10 - no further F/u needed from Urgent Care.
Age: 84.0
Sex: F
Vaccine: FLUX
Symptoms: Adverse reaction, Anxiety, Blood pressure increased, Flushing, Hyperhidrosis
Clinical narrative: About 4 hours after vaccine became flushed and soaked in sweat. Anxious and uneasy feeling. BP elevated. Was taken to ER. Told reaction to flu shot.
Age: 58.0
Sex: F
Vaccine: FLUX, FLUX(H1N1)
Symptoms: Blood test, Disorientation, Dizziness, Dyspnoea, Pyrexia
Clinical narrative: Rash, on and off fever, lightheaded disoriented, hard to breathe.
Age: 58.0
Sex: F
Vaccine: FLUX, FLUX(H1N1)
Symptoms: Rash
Clinical narrative: Rash, on and off fever, lightheaded disoriented, hard to breathe.
Age: 57.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Drug hypersensitivity, Eye irritation, Headache, Latex allergy, Nausea
Clinical narrative: Vomiting 2 1/2 days - allergic to neomycin - sore throat burning of eyes (red) fever 102, severe headache B/P 165/110 with meds 3rd day until present nauseated Rx - PHENERGAN HCL 12.5 mg q 6 hrs - low grade fever.
Age: 57.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Ocular hyperaemia, Oropharyngeal pain, Pyrexia, Vomiting
Clinical narrative: Vomiting 2 1/2 days - allergic to neomycin - sore throat burning of eyes (red) fever 102, severe headache B/P 165/110 with meds 3rd day until present nauseated Rx - PHENERGAN HCL 12.5 mg q 6 hrs - low grade fever.
Age: 57.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Abdominal discomfort, Asthenia, Blood pressure increased, Body temperature increased, Condition aggravated
Clinical narrative: Vomiting 2 1/2 days - allergic to neomycin - sore throat burning of eyes (red) fever 102, severe headache B/P 165/110 with meds 3rd day until present nauseated Rx - PHENERGAN HCL 12.5 mg q 6 hrs - low grade fever.
Age: 57.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Drug hypersensitivity, Eye irritation, Feeling hot, Headache, Heart rate decreased
Clinical narrative: Vomiting 2 1/2 days - allergic to neomycin - sore throat burning of eyes (red) fever 102, severe headache B/P 165/110 with meds 3rd day until present nauseated Rx - PHENERGAN HCL 12.5 mg q 6 hrs - low grade fever.
Age: 57.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Hyperhidrosis, Hypersensitivity, Injection site pruritus, Injection site swelling, Myalgia
Clinical narrative: Vomiting 2 1/2 days - allergic to neomycin - sore throat burning of eyes (red) fever 102, severe headache B/P 165/110 with meds 3rd day until present nauseated Rx - PHENERGAN HCL 12.5 mg q 6 hrs - low grade fever.
Age: 57.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Nausea, Oropharyngeal pain, Pain, Pyrexia, Throat tightness
Clinical narrative: Vomiting 2 1/2 days - allergic to neomycin - sore throat burning of eyes (red) fever 102, severe headache B/P 165/110 with meds 3rd day until present nauseated Rx - PHENERGAN HCL 12.5 mg q 6 hrs - low grade fever.
Age: 57.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Vomiting
Clinical narrative: Vomiting 2 1/2 days - allergic to neomycin - sore throat burning of eyes (red) fever 102, severe headache B/P 165/110 with meds 3rd day until present nauseated Rx - PHENERGAN HCL 12.5 mg q 6 hrs - low grade fever.
Age: 0.51
Sex: M
Vaccine: DTAPIPVHIB, FLU3
Symptoms: Pyrexia
Clinical narrative: Fever 102. 4 degrees.
Age: 5.0
Sex: F
Vaccine: FLU3
Symptoms: Corneal reflex decreased, Tic, Trismus
Clinical narrative: Tic reaction 2hrs after vaccination - lasted approximately 24 hr - resolved. (1) eye blinking (2) jaw movements.
Age: 76.0
Sex: M
Vaccine: FLU3
Symptoms: Dyspnoea
Clinical narrative: Received shot at 800 pm 12/1/10 -> At 200 am 12/2/10 pt was having problems with shortness of breath. No problems with injection site or nausea.
Age: 34.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Cough, Headache, Nausea, Pyrexia
Clinical narrative: 4 1/2 hrs with administrations vaccine c/o cough nausea; fever; chills; HA -better after 24 hours.
Age: 11.0
Sex: M
Vaccine: FLU3, HPV4, MEN, TDAP
Symptoms: Oedema peripheral, Rash
Clinical narrative: SWOLLEN ARMS, RASH
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Injection site pruritus, Pruritus, Rash
Clinical narrative: 12/9/2010 5 minutes after vaccine administration: Patient complained of itching on upper arm vaccine was administered in and under her nose. Upon inspection patient pointed at site above injection site that was red due to scratching. She also had obvious dry, flaking skin. Patient was given 2 chewable Benadryl tablets and itching resolved. Instructed patient to take APAP and apply cold compress to help with redness and swelling. Also to note, patient was extremely tensed when vaccine was administered. 12/13/2010: Patient called complaining rash has gotten bigger. States yesterday it was raised, but that has subsided and she just has a red patch the size of a softball. Also reports itching that has also subsided with taking Benadryl. Did not use a cold compress or Tylenol as instructed by me on Friday. Since rash seems to be resolving again suggested cold compress and Tylenol. Instructed her to come in if she wanted us to take a look at it or if it gets worse as it may take up to a week to resolve.
Age: 2.0
Sex: F
Vaccine: DTAPIPVHIB, HEPA, MMR, PNC13
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: right leg red and swollen
Age: 0.18
Sex: F
Vaccine: PNC13
Symptoms: Abdominal pain, Condition aggravated, Constipation, Diarrhoea, Flatulence
Clinical narrative: Increased irritability, interrupted sleep patterns and waking up screaming for no apparent reason, nearly impossible to soothe/calm, 10+ day periods of constipation with few minuscule watery bowl movements, and foul/frequent gas.  Doctor brushed off concerns as side effects of reflux.  Also blamed newly developed behaviors as "colic".
Age: 0.18
Sex: F
Vaccine: PNC13
Symptoms: Irritability, Screaming, Sleep disorder
Clinical narrative: Increased irritability, interrupted sleep patterns and waking up screaming for no apparent reason, nearly impossible to soothe/calm, 10+ day periods of constipation with few minuscule watery bowl movements, and foul/frequent gas.  Doctor brushed off concerns as side effects of reflux.  Also blamed newly developed behaviors as "colic".
Age: 75.0
Sex: M
Vaccine: FLU3
Symptoms: Influenza like illness, Malaise, Myalgia, Pyrexia
Clinical narrative: pt complained of flu like symptoms, myalgia, malaise, fever beginning 1 week after immunization
Age: 58.0
Sex: F
Vaccine: FLUX
Symptoms: Bedridden, Chills, Decreased appetite, Headache, Malaise
Clinical narrative: Severe body ache; headache; chills; fever; loss of appetite; severe sore throat- illness lasted 2 weeks; bedridden
Age: 58.0
Sex: F
Vaccine: FLUX
Symptoms: Oropharyngeal pain, Pain, Pyrexia, Streptococcus test negative
Clinical narrative: Severe body ache; headache; chills; fever; loss of appetite; severe sore throat- illness lasted 2 weeks; bedridden
Age: 28.0
Sex: M
Vaccine: SMALL
Symptoms: Infection, Injection site cellulitis, Injection site nodule, Injection site swelling, Staphylococcal infection
Clinical narrative: Service member began to experience swelling 6x4" at site and a knot on his left shoulder on Nov 15, 2010 SM went to PCM on Nov 17, 2010 for surgery to remove infected area. Fully recovered as of 4 Dec. 2010.
Age: 28.0
Sex: M
Vaccine: SMALL
Symptoms: Surgery
Clinical narrative: Service member began to experience swelling 6x4" at site and a knot on his left shoulder on Nov 15, 2010 SM went to PCM on Nov 17, 2010 for surgery to remove infected area. Fully recovered as of 4 Dec. 2010.
Age: 84.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Inflammation, Local swelling, Localised infection, Skin warm
Clinical narrative: Vaccine administered 9/30/10. Patient returned to pharmacy 16:15 with generalized swelling, redness on entire upper arm from shoulder to elbow, swelling and red and hot. Treated with Cephalexin for one week and now fine. Follow up done. MD felt pt had local swelling, inflammation and infection. Now resolved without lasting effects.
Age: 84.0
Sex: F
Vaccine: PPV
Symptoms: Swelling
Clinical narrative: Vaccine administered 9/30/10. Patient returned to pharmacy 16:15 with generalized swelling, redness on entire upper arm from shoulder to elbow, swelling and red and hot. Treated with Cephalexin for one week and now fine. Follow up done. MD felt pt had local swelling, inflammation and infection. Now resolved without lasting effects.
Age: 5.0
Sex: M
Vaccine: IPV, MMR, VARCEL
Symptoms: No adverse event, Wrong drug administered
Clinical narrative: TDAP ordered by provider. Given by MA. Reported as incorrect by MA. MD notified. No adverse effect noted to pt.
Age: 0.32
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV5
Symptoms: Adenovirus test positive, Culture stool positive, Intussusception, Rotavirus test negative, Surgery
Clinical narrative: Developed Ileocolic Intussusception 4 days after 2nd dose of ROTATEQ requiring surgical intervention.
Age: 35.0
Sex: M
Vaccine: HEP, MNQ
Symptoms: Incorrect dose administered
Clinical narrative: Provider ordered Hep A and MENACTRA given by MA. Provider indicated after given that not needed. Patient had already been immunized.
Age: 35.0
Sex: F
Vaccine: TDAP
Symptoms: Urticaria
Clinical narrative: Systemic urticaria reaction.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, PNC13
Symptoms: Body temperature increased, Pain in extremity
Clinical narrative: Temperature of 103 leg pain.
Age: 59.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site nodule, Lymphadenopathy
Clinical narrative: 24 hr. after vaccination, patient stated she had a swollen knot the size of a small orange on her left deltoid region in addition to swollen lymph nodes in left armpit area. Patient alternated warm & cool compresses with MOTRIN by mouth. Today 12/7/10 the know is the size of a quarter.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5
Symptoms: Convulsion, Crying, Electroencephalogram normal, Fatigue, Feeling hot
Clinical narrative: 11-3-10 seizure at 3 pm. Seen by primary care physician - admitted to hospital seizure plus high pitch cry x 2 days. Cry would stop when held or fed. EEG - normal, spinal tap - negative for meningitis. No Rx prescribed for seizures. Mother stated child is "less fussy since taking off milk - still has some shaking when he becomes to warm or tired".
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5
Symptoms: Irritability, Lumbar puncture normal, Tremor
Clinical narrative: 11-3-10 seizure at 3 pm. Seen by primary care physician - admitted to hospital seizure plus high pitch cry x 2 days. Cry would stop when held or fed. EEG - normal, spinal tap - negative for meningitis. No Rx prescribed for seizures. Mother stated child is "less fussy since taking off milk - still has some shaking when he becomes to warm or tired".
Age: 42.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
Clinical narrative: Severe redness/swelling/pain/fever dorsal Lt upper arm onset 4-5 days after immunization.
Age: 1.03
Sex: M
Vaccine: HEPA, MMR, VARCEL
Symptoms: Ataxia, Full blood count normal, Irritability, Pyrexia, Rash
Clinical narrative: Fever, rash, irritability for 48 hrs 3-4 days after vaccine, also slight ataxia. Resolved after 48 hours.
Age: 4.0
Sex: M
Vaccine: PNC13
Symptoms: Bronchitis, Chest pain, Dehydration, Lethargy, Local swelling
Clinical narrative: This case was considered medically important for the event of bronchitis. Information regarding PREVNAR 13 was received from a consumer regarding a 4-year-old male patient who experienced arm swelling, bronchitis and dehydrated. At 4 years of age, the patient received a dose on 05-Oct-2010. On 05-Oct-2010, after being administered the PREVENAR 13 vaccine, the patient experienced arm swelling. The following day, he complained of chest pain and threw up for about 12 hours. On 07-Oct-2010, the patient was lethargic and was taken to the Emergency Room. He was diagnosed with bronchitis. he was also noted to be dehydrated. Outcome was unknown. No additional information was available at the time of this report. Follow-up 02DED2010: Following the integration of the legacy safety adverse event reporting databases, this case has been migrated from the legacy company database into the current safety database for processing follow-up information. As a consequence of this migration, the follow-up CIOMS I or Med Watch report may indicate in the appropriate field that it is an initial report. Follow-up received from a contactable physician. The patient recovered from the events on an unknown date. No other new information provided.
Age: 4.0
Sex: M
Vaccine: PNC13
Symptoms: Vomiting
Clinical narrative: This case was considered medically important for the event of bronchitis. Information regarding PREVNAR 13 was received from a consumer regarding a 4-year-old male patient who experienced arm swelling, bronchitis and dehydrated. At 4 years of age, the patient received a dose on 05-Oct-2010. On 05-Oct-2010, after being administered the PREVENAR 13 vaccine, the patient experienced arm swelling. The following day, he complained of chest pain and threw up for about 12 hours. On 07-Oct-2010, the patient was lethargic and was taken to the Emergency Room. He was diagnosed with bronchitis. he was also noted to be dehydrated. Outcome was unknown. No additional information was available at the time of this report. Follow-up 02DED2010: Following the integration of the legacy safety adverse event reporting databases, this case has been migrated from the legacy company database into the current safety database for processing follow-up information. As a consequence of this migration, the follow-up CIOMS I or Med Watch report may indicate in the appropriate field that it is an initial report. Follow-up received from a contactable physician. The patient recovered from the events on an unknown date. No other new information provided.
Sex: F
Vaccine: FLU3
Symptoms: Bronchitis, Chest pain, Dehydration, Influenza, Influenza A virus test positive
Clinical narrative: Initial report received from the patient's daughter on 29 November 2010; and follow-up information was received via telephone call to the patient's daughter on 01 December 2010. A female patient had received a dose of Influenza vaccine (trade name, manufacturer name, lot number, route and site of administration unknown) on an unknown day in September 2010 and one month later was diagnosed with influenza Type A. It was unknown if the patient had any illnesses, pre-existing medical conditions, or use of other medications at the time of vaccination; nor was it known if the patient required any treatment for the influenza. Recovery status was unknown. Documents held by sender: None.
Sex: F
Vaccine: FLU3
Symptoms: Lethargy, Oedema peripheral, Vomiting
Clinical narrative: Initial report received from the patient's daughter on 29 November 2010; and follow-up information was received via telephone call to the patient's daughter on 01 December 2010. A female patient had received a dose of Influenza vaccine (trade name, manufacturer name, lot number, route and site of administration unknown) on an unknown day in September 2010 and one month later was diagnosed with influenza Type A. It was unknown if the patient had any illnesses, pre-existing medical conditions, or use of other medications at the time of vaccination; nor was it known if the patient required any treatment for the influenza. Recovery status was unknown. Documents held by sender: None.
Sex: M
Vaccine: FLUX
Symptoms: Musculoskeletal pain, Neuralgic amyotrophy, Pain in extremity, Paraesthesia
Clinical narrative: Initial report received from a consumer on 30 November 2010. A male patient (age not reported) received in October 2010 a left arm injection (route not reported) of INFLUENZA VACCINE, lot number not reported. The patient's medical history was not provided. The patient received the injection in the left arm and the next day developed pain in the arm and shoulder of the right arm with muscle tingling. The pain continued for two weeks. The patient had seen a health care provider (HCP) and was diagnosed with Parsonage-Turner Syndrome. The patient's identifiers was declined to be given by reporter who also had no further information to report and did not want any future contact. The outcome was reported as unknown. Documents held by sender: None.
Age: 64.0
Sex: F
Vaccine: VARZOS
Symptoms: Headache
Clinical narrative: SLIGHT HEADACHE AROUND EYES
Age: 69.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Feeling hot, Flushing
Clinical narrative: Pt became flushed in face and complained of "I feel so hot."
Age: 1.0
Sex: F
Vaccine: FLU3, HEPA, HIBV, MMR, VARCEL, FLU3, HEPA, HIBV, MMR, PNC13, VARCEL
Symptoms: Erythema, Rash macular
Clinical narrative: Macular reddish rash over much of torso.
Age: 1.0
Sex: F
Vaccine: FLU3, HEPA, HIBV, MMR, VARCEL, FLU3, HEPA, HIBV, MMR, PNC13, VARCEL
Symptoms: Rash generalised
Clinical narrative: Macular reddish rash over much of torso.
Age: 48.0
Sex: M
Vaccine: FLU3
Symptoms: Abdomen scan normal, Abdominal pain upper, Arthralgia, Cough, Electrocardiogram normal
Clinical narrative: 8/10 epigastric pain, nonradiating with severe arthralgias. Positive for rhinorrhea and wheezing cough. No fever or chills.
Age: 48.0
Sex: M
Vaccine: FLU3
Symptoms: Full blood count normal, Liver function test normal, Rhinorrhoea, Wheezing
Clinical narrative: 8/10 epigastric pain, nonradiating with severe arthralgias. Positive for rhinorrhea and wheezing cough. No fever or chills.
Age: 19.0
Sex: F
Vaccine: FLU3, PPV, TDAP
Symptoms: Abdominal pain upper, Diarrhoea, Headache, Injection site erythema, Injection site swelling
Clinical narrative: 48 hours red, raised area 1 inch x 3 inches on Left Deltoid, malaise, diarrhea, nausea, stomach pain/body ache, rash on trunk, Left hip, headache.
Age: 19.0
Sex: F
Vaccine: FLU3, PPV, TDAP
Symptoms: Malaise, Nausea, Pain, Rash
Clinical narrative: 48 hours red, raised area 1 inch x 3 inches on Left Deltoid, malaise, diarrhea, nausea, stomach pain/body ache, rash on trunk, Left hip, headache.
Age: 0.53
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Hypersensitivity, Rash, Urticaria, Vaccination site rash
Clinical narrative: Parents report onset of rash, distal extremities later in the day after vaccine administration.  Went to ER at hospital, diagnosed with allergic reaction and treated with diphenhydramine.  Denied fever, change in eating habits, irritability or pruritis.  Rash progressed to trunk and parents went to second Emergency Room at hospital on 12/1/2010, diagnosed with urticaria and treated with diphenhyrdamine.  Per parents rash quickly resolved.
Age: 52.0
Sex: M
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: REDNESS, SWELLING AND PAIN AND WARMTH TO THE INJECTION SITE
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Erythema, Pruritus, Scab
Clinical narrative: Employee described "itchy" at upper arm on 12/3/10 as we were passing in hall.  Later, on 13/13/10- Employee states the upper arm became red and increased with redness, gradually. While employee working she called- via phone the Emergency Room on 12/05/10 and consulted with staff asking what they thought- at which time it was suggested that employee take Benadryl; however, employee did not take Benadryl, and redness gradually subsided.  I personally assessed the arm today- faint redness noted below deltoid area.  I also noted a small (1cm x 0.5cm)partially open area with partial scab 3 inches or greater below deltoid.  Employee " I'm not sure where she got that from." Note: itching, per employee, began 3 days after immunization (Tdap- Sanofi Pastuer)
Age: 35.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Pruritus, Skin warm, Swelling
Clinical narrative: Notice large area of swelling, redness, and heat approximately 8 hours after injection, Measured 40X50 mm. Itiching after 24 hrs.
Age: 70.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Asthenia, Diarrhoea, Dizziness, Muscle spasms, Nausea
Clinical narrative: Nausea, vomiting, diarrhea, weakness, dizziness, cramps
Age: 70.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Vomiting
Clinical narrative: Nausea, vomiting, diarrhea, weakness, dizziness, cramps
Age: 62.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Erythema, Injected limb mobility decreased, Oedema peripheral, Pain in extremity, Skin warm
Clinical narrative: Left arm began to ache, swell, was warm to the touch and red. Patient could hardly raise his arm.
Age: 36.0
Sex: F
Vaccine: FLU3
Symptoms: Arthralgia, Musculoskeletal pain, Pain, Pain in extremity, Skin warm
Clinical narrative: Hot soreness surging through shoulder and down arm, pain in joint. Took some Tylenol throughout the rest of day. Next day, and every day since, there is pain in shoulder joint, painful to lift or rotate arm at shoulder.
Age: 4.0
Sex: M
Vaccine: MMR
Symptoms: Chills, Pain, Salivary gland pain
Clinical narrative: Mother developed body aches, chills, and severe parotid gland soreness. Mother was immunized for MMR as a child, had Chicken Pox at 17 years of age, and takes immunosuppressive medications (prednisone 7mg daily x 6 years, Cellcept 500mg po bid X 7 months, Humira 40mg SQ every 14 days, first and only dose on 12/7/10)
Age: 0.21
Sex: F
Vaccine: DTAP
Symptoms: Strabismus
Clinical narrative: Crossed eyes for two days
Age: 0.47
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC13, RV1
Symptoms: Body temperature increased, Diet refusal, Lethargy, Respiratory tract congestion, Vomiting
Clinical narrative: Lethargic, congestion, not eating, vomiting, T 99.6
Age: 68.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site rash, Lip swelling, Oral herpes
Clinical narrative: Pt reported swollen lips, a cold sore and rash at injection site.
Age: 28.0
Sex: F
Vaccine: FLU(H1N1), FLU3
Symptoms: Burning sensation, Drug exposure during pregnancy, Dyspnoea
Clinical narrative: Within a hour of receiving both sesonal and H1N1 injectable vaccines felt like lungs were on fire and difficulty breathing. Presented to ER and was given Epi and Benadryl. Received monitoring and IV fluids and discharged.
Age: 55.0
Sex: M
Vaccine: FLU3
Symptoms: Anxiety, Chest pain, Conjunctival hyperaemia, Diarrhoea, Dyspnoea
Clinical narrative: Patient began to feel achy, with Shortness of breath and R sided chest pain, Nausea, and 2 episodes of diarrhea.  "Felt like gonna die" Anxious, flushed, tachycardic, conjunctival injection.  No edema, no rash, no trouble swallowing, no lightheadedness or dizziness.  BP 124/88, RR 20, HR 140 -- 122, Pulse ox 94-95%  Pt given Decadron 8 mg IM with improvement in symptoms. Had normal EKG except for sinus tachycardia.  Pt refused Chest Xray. Pt refused (AMA) transport to Emergency Room and refused to go to Emergency Room.  Discharged in stable condition with prednisone taper from Urgent Care office.
Age: 55.0
Sex: M
Vaccine: FLU3
Symptoms: Electrocardiogram normal, Flushing, Nausea, Pain, Sinus tachycardia
Clinical narrative: Patient began to feel achy, with Shortness of breath and R sided chest pain, Nausea, and 2 episodes of diarrhea.  "Felt like gonna die" Anxious, flushed, tachycardic, conjunctival injection.  No edema, no rash, no trouble swallowing, no lightheadedness or dizziness.  BP 124/88, RR 20, HR 140 -- 122, Pulse ox 94-95%  Pt given Decadron 8 mg IM with improvement in symptoms. Had normal EKG except for sinus tachycardia.  Pt refused Chest Xray. Pt refused (AMA) transport to Emergency Room and refused to go to Emergency Room.  Discharged in stable condition with prednisone taper from Urgent Care office.
Age: 55.0
Sex: M
Vaccine: FLU3
Symptoms: Tachycardia
Clinical narrative: Patient began to feel achy, with Shortness of breath and R sided chest pain, Nausea, and 2 episodes of diarrhea.  "Felt like gonna die" Anxious, flushed, tachycardic, conjunctival injection.  No edema, no rash, no trouble swallowing, no lightheadedness or dizziness.  BP 124/88, RR 20, HR 140 -- 122, Pulse ox 94-95%  Pt given Decadron 8 mg IM with improvement in symptoms. Had normal EKG except for sinus tachycardia.  Pt refused Chest Xray. Pt refused (AMA) transport to Emergency Room and refused to go to Emergency Room.  Discharged in stable condition with prednisone taper from Urgent Care office.
Age: 38.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Pain, Pain in extremity
Clinical narrative: PAIN IN ARM, MOSTLY WHEN SHE TRIES TO LIFT ARM OR PUSH WITH IT.
Age: 38.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Mobility decreased, Pain in extremity
Clinical narrative: PAIN IN ARM, MOSTLY WHEN SHE TRIES TO LIFT ARM OR PUSH WITH IT.
Age: 1.0
Sex: F
Vaccine: HEP, MMR, VARCEL
Symptoms: Abnormal behaviour, Crying, Gaze palsy, Hypotonia, Irritability
Clinical narrative: Mother called 12/9/10 to report child had experienced an event Tues evening.  she did not know if it was a reaction to vaccines received that day or just a coincidence.  To celebrate child's birthday, she had given her a cupcake with a lighted candle.  Child reached for candle, felt heat and immediately withdrew her hand.  No sign of a burn.  Child did cry, but a normal cry.  Her color turned a deep purple, she quit breathing, her head fell back, she went limp, and her eyes opened and shut and rolled back.  Just as mom was about to call 911, child started to recover.  She seemed a little dazed and whimpered a little.  Child remained awake a couple of hrs after event and behaved normally.  Mom has noted no other unusual behavior, no rashes, and no fever.  This child is mom's 4th - other 3 children received vaccines and may have needed a Tylenol or Motrin but otherwise had no problems.  This child has responded differently - fussier and needed more attention after her vaccines.
Age: 1.0
Sex: F
Vaccine: HEP, MMR, VARCEL
Symptoms: Posture abnormal, Respiratory arrest, Skin discolouration
Clinical narrative: Mother called 12/9/10 to report child had experienced an event Tues evening.  she did not know if it was a reaction to vaccines received that day or just a coincidence.  To celebrate child's birthday, she had given her a cupcake with a lighted candle.  Child reached for candle, felt heat and immediately withdrew her hand.  No sign of a burn.  Child did cry, but a normal cry.  Her color turned a deep purple, she quit breathing, her head fell back, she went limp, and her eyes opened and shut and rolled back.  Just as mom was about to call 911, child started to recover.  She seemed a little dazed and whimpered a little.  Child remained awake a couple of hrs after event and behaved normally.  Mom has noted no other unusual behavior, no rashes, and no fever.  This child is mom's 4th - other 3 children received vaccines and may have needed a Tylenol or Motrin but otherwise had no problems.  This child has responded differently - fussier and needed more attention after her vaccines.
Age: 1.03
Sex: M
Vaccine: FLU3, HEPA, MMR, VARCEL
Symptoms: Pyrexia, Rash, Rash macular
Clinical narrative: Fever one week after vaccine, maximum 102 degrees of 3 days duration followed by macular red rash on torso and face
Age: 0.92
Sex: M
Vaccine: HIBV
Symptoms: Urticaria
Clinical narrative: urticarial like rash that did not improve with antihistamines
Age: 33.0
Sex: F
Vaccine: FLUX
Symptoms: Fatigue, Injected limb mobility decreased, Injection site pain, Malaise, Pain
Clinical narrative: Symptoms: Very sore arm where the shot got administered - hard to even lift it. Also: fever, malaise, great tiredness, body aches. All except the sore arm went away within 24 hours. The arm remained sore for about 2 days.
Age: 33.0
Sex: F
Vaccine: FLUX
Symptoms: Pyrexia
Clinical narrative: Symptoms: Very sore arm where the shot got administered - hard to even lift it. Also: fever, malaise, great tiredness, body aches. All except the sore arm went away within 24 hours. The arm remained sore for about 2 days.
Age: 36.0
Sex: F
Vaccine: FLUX
Symptoms: Injection site erythema, Injection site haematoma, Injection site pain, Injection site swelling
Clinical narrative: Swollen upper arm from site of injection to elbow. Red, painful to touch. This lasted 6 days.  Redness, swelling went away, followed by small yellow bruise at site of injection. Bruise lasted for 2-3 days.
Age: 18.0
Sex: M
Vaccine: FLUN3, HPV4
Symptoms: Anxiety, Cold sweat, Dizziness, Feeling abnormal, Pallor
Clinical narrative: Dizziness, uneasiness within minutes of receiving shot. Found to have pallor, cold clammy skin, thin thready pulse. Was given BENADRYL and Epinephrine. Free flow oxygen. Took 15-20 minutes for recovery of good pulse volume and blood pressure.
Age: 18.0
Sex: M
Vaccine: FLUN3, HPV4
Symptoms: Pulse abnormal
Clinical narrative: Dizziness, uneasiness within minutes of receiving shot. Found to have pallor, cold clammy skin, thin thready pulse. Was given BENADRYL and Epinephrine. Free flow oxygen. Took 15-20 minutes for recovery of good pulse volume and blood pressure.
Age: 46.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Dizziness, Dyspnoea, Fatigue, Influenza like illness
Clinical narrative: Civilian employee noticed the onset of dizziness and lightheadedness then flu-like symptoms commencing 1-2 days after influenza vaccine. Received IM Flu vaccine on 11/17/10. Pt claims the vaccine disturbed her SLE by causing her urinalysis to become abnormal where the UA results had previously been negative. Civilian noted the gradual onset of a "flu-like illness" with upper airway and chest congestion, productive cough with white mucus, chills, malaise, and fatigue. No fever documented. Patient would experience some shortness of breath when going up a flight of stairs about 1-2 weeks later. She took her pulse ox and it measured 93-94%. She was diagnosed with a URI about 2 weeks later and the illness took quite some time to resolve.
Age: 46.0
Sex: F
Vaccine: FLU3
Symptoms: Malaise, Productive cough, Respiratory tract congestion, Upper respiratory tract infection, Urine analysis abnormal
Clinical narrative: Civilian employee noticed the onset of dizziness and lightheadedness then flu-like symptoms commencing 1-2 days after influenza vaccine. Received IM Flu vaccine on 11/17/10. Pt claims the vaccine disturbed her SLE by causing her urinalysis to become abnormal where the UA results had previously been negative. Civilian noted the gradual onset of a "flu-like illness" with upper airway and chest congestion, productive cough with white mucus, chills, malaise, and fatigue. No fever documented. Patient would experience some shortness of breath when going up a flight of stairs about 1-2 weeks later. She took her pulse ox and it measured 93-94%. She was diagnosed with a URI about 2 weeks later and the illness took quite some time to resolve.
Age: 27.0
Sex: F
Vaccine: FLU3
Symptoms: Dizziness, Tremor
Clinical narrative: 10:10 am - Sx onset - dizziness, hand tremors 10 min after vaccination. Placed in supine position BP-130/78, P-96, BS 93. 10:40 no change, general malaise. 50mg BENADRYL given as precaution. 11:30 Sx better. 1 pm - felt nl again.
Age: 54.0
Sex: M
Vaccine: FLU3
Symptoms: Nausea, Pyrexia
Clinical narrative: Low grade fever, nausea.
Age: 1.58
Sex: F
Vaccine: FLU3
Symptoms: Eating disorder, Lip disorder, Tearfulness
Clinical narrative: Patient assessed today (12/13/10) with signs/symptoms of Bells Palsy. Symptoms started on Saturday 12/11/10. Her lip goes to the side when smiles, and can't eat well because food falls out. No fever. Left eye is more tearful. Has been approximately 1 month from the vaccine, but no other changes have been seen.
Age: 53.0
Sex: M
Vaccine: FLUX
Symptoms: Computerised tomogram normal, Nuclear magnetic resonance imaging brain abnormal, Ultrasound Doppler, VIIth nerve paralysis
Clinical narrative: Rt. side facial droop - MRI brain (small focus abnormal T2 signal (L) insular cortex); carotid US was negative; CT negative. Dx'd with Bell's Palsy.
Age: 72.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site inflammation
Clinical narrative: Patient received injection of AFLURIA on 10/25/10 at the hospital's annual flu clinic. The patient is still experiencing extreme inflammation at injection site. The patient alternated warm moist and cold packs to the area.
Sex: M
Vaccine: FLU3
Symptoms: Arthralgia, Joint range of motion decreased, Muscle spasms, Myalgia
Clinical narrative: Initial report was received from a consumer who is also the patient on 01 December 2010. A male patient (age and past medical history not reported), had received an influenza vaccine (manufacturer, lot number, route and site of administered not reported) on either 22 or 23 September 2010, and an unspecified amount of time later experienced" continuous shoulder muscle spasm (knotted painful muscle) for eight weeks" and "shoulder joint pain and limitation in joint mobility of moderate intensity for eight weeks". No further information was available at the time of the report. The patient reported residual joint pain "now" after ten weeks. Documents held by sender: none.
Age: 71.0
Sex: F
Vaccine: FLU3
Symptoms: Asthenia, Cough, Headache, Malaise, Pain
Clinical narrative: Initial consumer (patient) report received on 30 Nov 2010: This patient with an unknown medical history was vaccinated with FLUVIRIN (batch number: unknown) 0.5 ml dose, on 03 Oct 2010. The patient started feeling sick, with constant headaches on 05 Oct 2010. 11 days later on an unknown date, she developed body aches, fever and cough which lasted for about 14 days. The patient also presented with severe rash on her thighs and lower abdomen, lost weight (10 pounds) and developed a severe urinary tract infection (UTI) on 25 Oct 2010. The events resolved but the patient was still little weak at the time of reporting.
Age: 71.0
Sex: F
Vaccine: FLU3
Symptoms: Pyrexia, Rash, Urinary tract infection, Weight decreased
Clinical narrative: Initial consumer (patient) report received on 30 Nov 2010: This patient with an unknown medical history was vaccinated with FLUVIRIN (batch number: unknown) 0.5 ml dose, on 03 Oct 2010. The patient started feeling sick, with constant headaches on 05 Oct 2010. 11 days later on an unknown date, she developed body aches, fever and cough which lasted for about 14 days. The patient also presented with severe rash on her thighs and lower abdomen, lost weight (10 pounds) and developed a severe urinary tract infection (UTI) on 25 Oct 2010. The events resolved but the patient was still little weak at the time of reporting.
Age: 21.0
Sex: F
Vaccine: MNQ
Symptoms: Alpha 1 globulin increased, Alpha 2 globulin increased, Bacterial test negative, Beta globulin increased, Blood creatine phosphokinase MB normal
Clinical narrative: Initial physician report received on 01 Dec 2010: This patient with unknown medical history was vaccinated with MENVEO in the left deltoid muscle on 09 Nov 2010. In the evening of 09 Nov 2010, the patient developed erythema with itching at injection site. On 10 Nov 2010, she noticed severe swelling in left upper arm with local feeling of both hyperthermia and tension. The above did not experience any deterioration of the general condition and fever was explicitly denied. Evidently on the same day, the patient presented at the hospital and was admitted. On admission, the patient was differentially diagnosed with vaccination reaction in left upper arm, and analysis of (potentially) beginning infection. The patient was in good general and nutritional condition. Gross clinical and gross neurological examination did not reveal any pathological findings, but the axillary nodes of left side were slightly enlarged. No other nodes were identified at palpation, Skin examination revealed sharply delimited erythema, with marked hyperthermic induration in latero-proximal region of left upper arm, i.e. over the deltoid muscle mass, on an area of about 10 times 15 cm. A prophylactic antibiotic therapy with cefuroxime was started at 750 mg 3 times daily accompanied by topical corticosteroid application with DERMOXIN ointment and local disinfection with CHINOSOL compresses and local cooling. Rapid improvement was observed with this treatment. Laboratory tests done on 14 Nov 2010 revealed elevated C-reactive protein of 1.17 mg/dL accompanied by normal creatine phosphokinase (CK) and normal MB isoenzyme (CK-MB), and normal both liver and pancreas enzymes. Total leukocytes (WBC) count and total protein were at upper boundary but still in normal range. Protein electrophoresis showed elevated percentages in alpha1-globulin, alpha2-globulin, and beta-globulin fractions. Further, elevated glucose and elevated triglycerides were observed. All other parameters in blood showed normal results. Urine status revealed no abnormalities. Analysis by flow cytometry revealed slight elevations in erythrocytes, leukocytes, and epithelial cells. Bacteria count was within normal range and no pathological cylinders were detected. Patient's condition improved and she was discharged on 15 Nov 2010 in good subjective condition. The patient was directed to continue treatment with DERMOXIN ointment for a maximum of 10 further days and of oral Cefuroxime, 250 mg 2 times daily for further 5 days.
Age: 21.0
Sex: F
Vaccine: MNQ
Symptoms: Blood creatine phosphokinase normal, Blood glucose increased, Blood triglycerides increased, C-reactive protein increased, Erythema
Clinical narrative: Initial physician report received on 01 Dec 2010: This patient with unknown medical history was vaccinated with MENVEO in the left deltoid muscle on 09 Nov 2010. In the evening of 09 Nov 2010, the patient developed erythema with itching at injection site. On 10 Nov 2010, she noticed severe swelling in left upper arm with local feeling of both hyperthermia and tension. The above did not experience any deterioration of the general condition and fever was explicitly denied. Evidently on the same day, the patient presented at the hospital and was admitted. On admission, the patient was differentially diagnosed with vaccination reaction in left upper arm, and analysis of (potentially) beginning infection. The patient was in good general and nutritional condition. Gross clinical and gross neurological examination did not reveal any pathological findings, but the axillary nodes of left side were slightly enlarged. No other nodes were identified at palpation, Skin examination revealed sharply delimited erythema, with marked hyperthermic induration in latero-proximal region of left upper arm, i.e. over the deltoid muscle mass, on an area of about 10 times 15 cm. A prophylactic antibiotic therapy with cefuroxime was started at 750 mg 3 times daily accompanied by topical corticosteroid application with DERMOXIN ointment and local disinfection with CHINOSOL compresses and local cooling. Rapid improvement was observed with this treatment. Laboratory tests done on 14 Nov 2010 revealed elevated C-reactive protein of 1.17 mg/dL accompanied by normal creatine phosphokinase (CK) and normal MB isoenzyme (CK-MB), and normal both liver and pancreas enzymes. Total leukocytes (WBC) count and total protein were at upper boundary but still in normal range. Protein electrophoresis showed elevated percentages in alpha1-globulin, alpha2-globulin, and beta-globulin fractions. Further, elevated glucose and elevated triglycerides were observed. All other parameters in blood showed normal results. Urine status revealed no abnormalities. Analysis by flow cytometry revealed slight elevations in erythrocytes, leukocytes, and epithelial cells. Bacteria count was within normal range and no pathological cylinders were detected. Patient's condition improved and she was discharged on 15 Nov 2010 in good subjective condition. The patient was directed to continue treatment with DERMOXIN ointment for a maximum of 10 further days and of oral Cefuroxime, 250 mg 2 times daily for further 5 days.