Sex: M
Vaccine: HEP
Symptoms: Diarrhoea, Enterococcal infection, Faeces discoloured, Fatigue, Gastroenteritis
Clinical narrative: Information has been received from medical records concerning a 5 week old infant male who on 28-JUN-2007 was vaccinated intramuscularly with with the first dose of RECOMBIVAX HB. Concomitant therapy included ERYTHROMYCIN eye drops and PHYTONADIONE given at birth. On 01-AUG-2007 the baby was seen by his physician with questionable colic. The baby's mother reported that the baby had cried from 7:00 am until noon on 31-JUL-2007. He had several episodes of loose runny stool. No blood was noted in the stool. There was no emesis and her had been afebrile and had been making good wet diapers. Upon examination, the baby was fussy and had loose stools and symptoms suggestive of an acute gastroenteritis which had resolved. It was reported that this was not suggestive of colic at that point. On 24-AUG-2007 the baby was seen with sinus congestion times two days, fever, rhinorrhea, fatigue, cough, and fussiness. Temperature upon examination was 98.7. The baby was assessed for viral upper respiratory infection and treated with rest, fluids, humidifier, bulb syringe use as needed, and nasal saline. On 27-AUG-2007, the infant was vaccinated with PREVNAR (lot #656269/1417F). On an unspecified date the infant was vaccinated with the first dose of ROTATEQ (MSD). On 02-OCT-2007 the baby experienced mild diarrhea and vomiting. The baby's mother was unsure if it had been more than 1 to 2 wet diapers in the last 24 hrs. The stool was described as liquid green foul smelling with no mucous. The baby was diagnosed with viral gastroenteritis. On 07-OCT-2007 the baby was seen in the emergency room due to vomiting and diarrhea. He had been vomiting times 7 days and was related to feeding which occurred approximately 5 minutes after each 4 ounce mild feeding. the emesis was clear. The diarrhea was brown and loose and had occurred two times in the previous 24 hours. There was no abdominal pain, fever or other associated symptoms. The baby's mother had been giving him clear liquids with some improvement in symptoms. Upon examination his vital signs included a pulse of 144, temperature 96. 8, respiratory rate 42 with a weight of 6.0 kg at SaO2 of 93%. He appeared healthy, alert and in no apparent distress. On 26-OCT-2007 the infant was vaccinated with PREVNAR (lot # "808681"). On 09-NOV-2007, the infant was vaccinated with ROTATAEQ (MSD) (lot # 657667/1392U). 20-NOV-2007 a culture was taken from a neck rash which showed moderate growth of enterococcus faecalis and moderate growth of staph aureus. The patient was treated with KEFLEX. On 26-DEC-2007 (also recorded as 27-DEC-2007) the infant was vaccinated with PREVNAR (lot # "B0868"), INFLUENZA (unspecified) and ROTATEQ vaccine (MSD) (lot #657667/1392U). On 18-JUN-2008, the patient was seen for follow up of thrush (onset 14-JAN-2008). The infant's mother reported that prescription NYSTATIN did resolve it but it seemed to keep coming back. The baby's mother also reported having gotten red of the old nipples and having had replaced them all. Since that time, the baby had no symptoms. The baby also developed a rash in his inner thighs. Upon examination on 18-JAN-2008, there was no thrush seen, and the tongue, lips and cheeks were clear. The diaper area had an erythematous rash with the leading edge and satellite lesions in the fat folds of the inner thighs bilaterally. Treatment included NYSTATIN suspension as needed and NYSTATIN ointment, and BALMEX or DESITIN. No further information is available.