Age: 0.2
Sex: M
Vaccine: HEP, IPV, PNC, HEP, IPV, PNC
Symptoms: Staring, Stupor, Visual disturbance, Vomiting
Clinical narrative: This report was originally received from Wyeth-Ayerst for Prevnar and was assigned manufacturer report number HQ3704215NOV2000 and concerns a 46 day old male patient with bullous impetigo who on 10/02/00 was vaccinated IM in the "left anterior left thigh" with a second dose of Hepatitis B vaccine recombinant (yeast) (lot #635268/0239K). Concomitant therapy on 10/02/00 included a first dose in the "right anterior left thigh" of Streptococcus Pneumoniae vaccine (Prevnar) (lot #473-337), a first dose SC in the "left anterior left thigh" of Poliovirus vaccine (IPOL) (lot #R1250) and Mupirocin (Bactroban). On 10/09/00 the patient was taken to the ER after he developed irritability, decreased oral intake, spitting up, strange episodes of not focusing, unusual startling and looking to his right side. He was transferred to the ER at a university medical center for further evaluation and was admitted to the pediatric neurology unit. A computerized tomogram of the head, urine analysis and "full sepsis evaluation" were normal. Blood and cerebrospinal fluid cultures were negative. Additional information has been requested. This was originally reported by a physician. The pt was presented to a hospital for concern of possible "infantile seizures." Mom reports that he has had a three day history of increase in "jerking episodes." Mom reports that whenever pt falls asleep or is quickly aroused or hears a loud noise, he has jerking with flexion of one arm extension of the other arm. Mom reports that previously she noticed this and was very normal, but in the past three days he has more of these responses and they seem to last longer than before. In the past 24 hours, mom became very concerned because she said her son is "lethargic" and acts as if he is in a "drunken stupor." Mom reports that usually he is up every three hours to eat four to six ounces which is very unusual. He would take four to six and feed more frequently throughout the day and play which he did not do today. He was just very listless. Mom reports that he has had decreased urine output but has managed to have one wet diaper every six hours. Mom reports that there has been no fever, no rhinorrhea, no cough, no diarrhea. He did have two episodes of emesis today and increased spitting up spisode, but she reports there has been no rash, while at the hospital. They described the pt as staring off to the right side, clinching his hands in a tight fist, makin his fingers white with the forcefulness of the clinch and flexing the arms at the elbow and holding them in at chest region for approx. five to ten seconds while staring off to the side followed by an abrupt extension of his arms with back an dneck extension followed by intense crying, fussiness for 15 seconds and then pt falls asleep. This was witnessed approx. two to three times at the outside ER. Follow up info received from a health professional reported that the pt recovered. No further info is available. F/U on 3/12/01, the pt was given a physical exam. At 7 months of age, the pt was 29 inches in heigh, 19 lbs an 46cm head circumference. A pysican exm of the GEN, HEENT, R.TM, L.TM, NECK, CHEST, CV, ABD, GU, M/S, NEURO,SKIN,were all reported as normal and the assessment was reported as well. On 3/17/01 a development questionaire was compleed. When your child is on his stomach on a flat surface can he lift his chest using his arms for support? YES. Does you baby ever make high-pitched or squealing sounds which are not crying? YES. Has you baby rolled over at least 2 times, from his stomach to his back or back to stomach? YES. Have you ever seen you child smiling at crib toys, pictures or pets when he is playing by himself? NOOPP (child has not had the chance to try). Soes you child focus his eyes on small objects the size of a pea, a raisin or a penny? YES.Is your child able to pick up a toy if it is placed within his reach? NO-OPP.  with you baby on his back, gently pull him up to a sitting osition by his wrists.(the baby does bring the head up with chin toward his chest, without the head falling back). Have you ever seen your baby pass something like a small block or a cookei from 1 hand to the other? Long objects like a spoon or rattles do not count. YES, Get you baby's attention with a scarf, handkerchief or a tissue and then drop it out of site. Did your baby try to find it? For example did he look for it under the table or behnd a chair? YES. Does you baby pick up 2 things (such a toys or cookies) and hold one in each hand at the same time? YES. Follow up info rec'd from hlth professional reported tha the pt recovered. No further info is available. this is an amended report. The lab value for the sputum macrophage count was listed as both 100 and 1000. This is a currected report as amended. Follow-up info received on 02/04/2002 reported that no further info had been received as of 01/28/2002 and that the pt had not received another dose of streptococcus pneumoniae vaccine or diphtheria toxoid pertussis vaccine tetanus toxoid. No furhter info is available.