Age: 76.0
Sex: F
Vaccine: PNC13
Symptoms: Axillary mass, Erythema, Induration, Injection site pain, Injection site pruritus
Clinical narrative: This is a spontaneous report from a contactable nurse reporting on a patient. A 76-year-old female patient received a dose of PREVNAR 13 (Lot number: J80525; Expiration date: 01Apr2016) 0.5ml single dose, intramuscular in left deltoid on 25Jan2015 at 2:00 pm. Medical history included allergic rhinitis, cause unspecified, asthma, atrial fibrillation on 11Jun2014, benign neoplasm of colon on 19Jul2013, cellulitis and abscess unspecified site on 27May2014, contact dermatitis with eczema on 27May2014, cough on 19Jul2013, diabetes mellitus type 2, dizziness and giddiness on 21May2014, essential hypertension unspecified on 11Jun2014, female stress incontinence on 21May2014, GERD, heartburn on 25Oct2013, irritable bowel syndrome, malaise, fatigue, obstructive sleep apnea, urinary incontinence, hyperlipidemia, overweight, palpitations on 04Oct2012, colonic polyps, reflux esophagitis on 02Apr2014, spinal stenosis, syncope on 10Jul2014, unspecified backache on 25Oct2013, unspecified sleep apnea on 02Apr2014, unspecified urinary incontinence on 04Oct2012, wheezing on 25Oct2013. The patient was allergic to the following drugs: aspirin, FELDENE, GLUCOPHAGE XR, LEVBID and NAPROSYN. Concomitant medications included betamethasone-clotrimazole 0.05%-1%, cream, topical, BID from 19Jul2013; calcium carbonate, 600 mg, tablet, oral once a day; DETROL LA, 4 mg, capsule extended release, oral, daily from 26Sep2013; FLONASE nasal, 50 mcg inhaler, 2 puff once a day as needed from 30Dec2013; FLOVENT, 110 mcg inhaler 2 puff 2 times a day as needed from 30Dec2013; glucosamine hydrochloride once a day; IMODIUM MULTI-SYMPTOM RELIEF, 2 mg/125 mg, oral, as needed; JANUVIA, 100 mg, tablet, oral 1/2 tablet once daily from 30May2014; pantoprazole 40 mg daily, delayed release tablet, oral, from 28Apr2014; simvastatin, 10mg once a day, tablet, oral from 03Mar2014; tolterodine L-tartrate ER 4 mg daily, capsule extended release, oral, from 02Jul2014; TUMS, 500 mg as needed, tablet chewable, oral; XARELTO tablet, oral, once a day, from 11Jun2014. The patient called office on 29Jan2015 with complaints of left upper extremity redness 3" in diameter, fell hard and tender to touch. Also had some axillary swelling and swelling occurred on her clavicle and up into her neck on the left side, extreme tenderness with severe itching at injection site. No difficulty swallowing or breathing. Patient was instructed to apply ice to affected areas and started CLARITIN and ZYRTEC daily. Patient called back on 02Feb2015 swelling along clavicle had turned to 2 hard lumps and neck fell stiff axillary lump was unchanged. Still taking cetirizine. Physician prescribed MEDROL and KEFLEX 500 mg tid x 7 days. On 11Feb2015 patient called back to report axillary and clavicle lumps were slowly resolving, no longer painful or itchy and slowly shrinking in size. Follow-up (27Feb2015): Additional information reported from the same contactable nurse includes age of the patient, route of administration, date of vaccination, anatomical location, clinical outcome of the events and information on concomitant and medical history. Events added.