Age: 17.0
Sex: F
Vaccine: HPV4
Symptoms: Biopsy lymph gland abnormal, Blood test normal, Computerised tomogram abdomen, Computerised tomogram abnormal, Lymph node pain
Clinical narrative: Information has been received from a nurse practitioner concerning a 17 year old female with a history of tonsillectomy and adenoidectomy when she was 5 years of age who on 10-JUN-2009 (lot# 661953/1130X, expiry: 13-MAR-2011), 05-AUG-2009 (lot# 662404, 0312Y, expiry: 30-APR-2011), and 07-DEC-2009 (lot# 663454/0672Y, expiry: 19-SEP-2011) was vaccinated IM with a first, second, and third 0.5 ml doses of GARDASIL (all were given in the upper extremities). Concomitant therapy included hormonal contraceptives (unspecified), ANAPROX and ZYRTEC as needed. In February 2010, the patient experienced bilateral swelling of lymph nodes of the groin measuring up to 1 cm a couple of months after completing the 3 doses schedule of GARDASIL. Lymph nodes were painful and the patient was nauseated. No other systemic or localized complaints. Biopsy of one node was read as "reactive". All radiographic and blood tests had been unremarkable. It was also reported ultrasound: normal, biopsy: normal, "blood work": normal. The patient sought medical attention via telephone. At the time of the report, the patient had not recovered. Follow up information has been received from a nurse practitioner concerning a 17 year old female student with an additional history of mononucleosis and no known drug allergies. In February 2010, the patient developed inguinal lymphadenopathy. The patient's mother called on 08-JUL-2010 to report this problem to the nurse practitioner's office. Lab tests pelvic ultrasound was done by another physician. The patient was diagnosed with reactive lymphs. The patient was treated with nonsteroidal anti-inflammatory drugs (NSAIDS) by the other physician. Blood tests were performed on 11-MAY-2010 and the results were normal. On 14-MAY-2010, pelvic ultrasound was performed and showed: small volume of endometrial fluid in present, this was presumably physiologic. No ovarian or adrenal mass. Bilateral inguinal lymph nodes were present which were borderline in size. On 01-JUN-2010, biopsy of lymph node in left inguinal was performed and showed slight reactive lymphoid hyperplasia and chronic inflammation. No evidence of primary or metastatic neoplasm. On 12-JUL-2010, CT scan was performed and showed: reactive size left inguinal lymph nodes seen, partially calcified, otherwise normal pelvic CT examination. CT scan of abdomen showed: no acute or chronic abnormal findings demonstrated on abdominal and pelvic CT study, normal examination. Gallbladder ultrasound was performed and showed that normal sonographically appearing gallbladder and limited evaluation of the tail of the pancreas due to superimposed bowel content. At the time of the report, the patient had not recovered. Follow up information has been received from mother of the patient who called to follow-up on any additional information she could obtain on the swelling because it had not gone down or gotten any better. She wanted to know if it would lead to cancer or any other illness. She would like to be contact with any additional information that has been learned. Follow-up information was received from the nurse practitioner who reported that the patient was no longer a patient at their office. No other complaints were reported by the patient since the first follow-up report. No further information is available.