Age: 0.33
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5, DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Colitis, Gastroenteritis, Gastrooesophageal reflux disease, Haematochezia, Intussusception
Clinical narrative: Information has been received concerning a 23 week old female, who was born with asymetric facies syndrome with no growth concerns or drug allergies, who was seen at a well child visit on 13 Jul 2006 with a history of being spitty and gaggy in the past week, with no vomiting, non bilious, non bloody stools, which were green jelly like with blood streaks, no fever and was feeding well. the patient was diagnosed with what appeared to be gastroesophageal reflux disease possibly with viral enteritis or breast milk colitis. A mild allergy was noted. It was reported that the plan was for complete blood cell count, a stool ova and parasites test, and to hold vaccines until the lab results were available. On 13 Jul 2006 the patient had a complete blood cell count with differential, a hematochezia stool culture with no salmonella, shigella, or Campylobacter isolated, and a stool white blood cell count showed moderate fecal leukocytes.  On 20 Jul 2006 there was no recurrence of blood in stool and the patient was okayed for 2 month immunizations. On 14 Sept 2006, at 9:50am, the patient was vaccainted with a first oral dose of rotavirus vaccine (lot 653915/0389F). Concomitant vaccine administered on the same day included an intramuscular first dose in the left leg of Pediarix (lot AC21B071AA), and intramuscular first dose in the right leg of Hibtiter (lot UE962AD), an intramuscular first dose in the right leg of Prevnar (lot B08651E). There were no other concomitant medications. There was no illness at the time of vaccination. On 25 Oct 2006 it was reported that the patient's mother called stating that the patient was gagging and spitting after feeding. Zantac was tried in the past without relief and was stopped. The patients last void was on 26 Oct 2006 at 10:15am. It was reported that the patient was vomiting four times per day for the past two days, mostly after breast feeding and formula. the child was brought into the emergency department. Two days prior the patient had one large stool. The patient experienced intermittent fussiness, and in the morning had one bloody stool. There was no fever or upper respiratory infection symptoms. The patient was diagnosed with intussusception with incomplete reduction by air enema. The plan was to admit the patient for an intussusception reduction procedure. A limited laparotomy with ileocolic intussusception reduction, and appendectomy was performed. There were no complications and the patient was discharged. On 16 Nov 2006, at a 6 month well child visit, it was noted that the patient had intussusception, but was doing well, and eating solids. There was no chronic diarrhea or constipation, Immunization were administered but rotavirus  vaccine was held. It was noted that the patient had recovered. A lot check was requested. The records of testing prior to release of the lot in question have been rechecked and found to be satisfactory. The lot met the requirements and was released. Additional information is not expected.