Age: 0.2
Sex: M
Vaccine: DTAP, HBHEPB, IPV
Symptoms: Hyperhidrosis, Irritability, Sudden infant death syndrome
Clinical narrative: June 21-24hrs pt screamed quite loudly when he received his immunizations and whimpered off and on afterward. The most immediate and noticeable change in pt was emotional and metabolic. He was unusually fussy and prone to crying and screaming. His normal stools were deep mustard in color and never runny. After the immunizations his stools were very loose, watery, a pale yellow color with a strong odor and the stools ran out the back of his diaper. He had frequent bowel movements like this throughout each day and they continued in this manner until he died. He was also noticeably sweaty with an oily smelling scalp, like someone who'd done a strenuous workout. This was not normal for pt. He would be bathed and this condition returned very quickly. Before his immunizations, pt enjoyed his baths. After his immunizations he would scream and cry the whole time he was bathed until he was dried off and clothed. The same would happen when he would be washed for a diaper change. He did not even enjoy being powdered anymore and this had been his favorite part of bathing. Mentally, I noticed at one point pt would stare directly in front of him as if in a trance. I would try to get his attention and he would not respond. After a short time pt would come out of this trance-like state and would growl. Pt seemed confused and upset when he came out of this trance-like state. I fully expected pt to be irritable for at least 72 hrs after his shots. Generally speaking this was my experience with my other 3 children after immunization. I also expected him to be very sleepy. To alleviate his discomfort, the Drs. advised the use of Tylenol drops. I medicated my other children in the same way with good success. With pt the Tylenol did not work. He was still very fussy and unhappy. I did not know what to think. But because my husband had cut teeth at 3 mos. of age I believe there was a possibility that pt was cutting teeth. I felt his gums and it was questionable but I thought there could be teeth under the gums. So I gave him teething medication. It seemed to help a little but not for long. He was back to fussing after a short time. I also noticed pt was unusually gassy and I thought this was due to the diarrhea. I thought this might be causing his fussiness. So I gave him gas drops. It seemed to help him pass some gas but it didn't help with the fussing. June 26 (five days)-We were also in the midst of a move so we also felt there was a change pt was upset because of the change. We had packed out our home and thought his fussiness might be because his things were packed away. While the movers were packing, I carried pt around in a carrier. He was fussy even then and I moved around quite a bit. He just continued not to be himself. June 27 (6 days)-Then when we moved to our temporary living facility, we thought perhaps the strangeness of the surroundings was upsetting pt. Pt's nature was such that he preferred being home in familiar surroundings, that's where he was happiest. The following thing were always helpful with pt in the past when he was fussy: nursing, rocking, swinging in his swing, sitting in his bouncy chair, being held, bathing him, and changing his diaper. Some of these thing helped a little after he was immunized but not for very long. Nursing was good until he'd eaten what he needed, then he'd be fussy, gassy and have diarrhea. Nothing we did really seemed to help keep pt content like he once was. Even pt's most favorite thing, being held, was of little consolation. At this point I was very concerned that we would not be able to keep pt calm long enough to make the plane trip across the ocean of the US. I was sure that people would become annoyed with us for having this very noisy baby. I thought to take pt to see the Dr. but I never took him in because I believed the Drs. would only tell me that I had a colicky child. We started putting pt in an adjoining room during meals because he was just constantly fussing, crying or screaming. I  would put him in his bouncy chair and as long as there was constant, vigorous motion he would not scream or cry. When we held him he was no longer happy to be still and held, he had to be in constant motion. The moment we stopped moving he would fuss or cry until he slept. July 5 (14 days)-This was particularly true to the night before his death. Just hours before his death, I needed a break from caring for pt. My husband hand oldest daughter took turns taking pt outside in the fresh air for a walk. He quieted down for that time that they were walking and they would bring him in. But within 5 minutes he would be back to screaming and crying. I tried to nurse pt to which he protested and I also held him as he continued to fuss and scream. This was one evening where we photographed pt. It was very hard to do because he didn't stop crying for very long. We did snap photos between the shot episodes of relative quiet. I can remember being very frustrated that he continued to fuss and cry no matter what we tried. This night pt's breathing was unusually noisy and wheezy sounding. But I thought it might be because he'd been having some congestion. The cold to warm weather changes tended to cause our family to get colds. So I just thought that he might have a cold. It was a tremendous relief when he finally slept at 10pm that night. This was also a little earlier than his normal 10:30-11:30pm bedtime. This night was also different again because we had packed away pt's portable crib that day as we anticipated boarding the plane in a day and a half. We had boxed up the bed to have it shipped through the post office. We made a bed for him on a comforter as we did when traveling and laid pt on the floor and on his stomach as I had done with all my children. I checked on pt at 1am and he seemed to be fine. He fussed at me a little as I adjusted his blanket. July 6 (2 weeks 16/17 hrs)- The next time I checked pt, it was 5 or 6 am on the morning of the 6th of July as he had not woken for his morning sleep. I went in the room which he shared with his 5 year old sister. He was very still and I noticed that he had moved himself to the corner of the room. I thought he looked odd. I could see his face, I picked him up and screamed for my husband. Pt did not move. We hysterically rushed about to the phone which was downstairs to call for help. Our eldest daughter telephoned. I hurried carried pt downstairs, my husband followed, hoping for some instruction which might help pt. We followed their instructions for infant CPR to no avail. The Emergency personnel arrived to took over. The girls and I prayed in the kitchen. The situation did not look hopeful. Pt was transported by ambulance to the ER. My husband I followed soon after in our own car. The doctors worked on pt for what seemed like an eternity. After a time they reported to us what we already feared was true, that pt was dead.