Age: 0.5
Sex: F
Vaccine: DTAP, HIBV, PNC, RV5
Symptoms: Endotracheal intubation, Gram stain positive, Head circumference normal, Lymphocyte percentage, Meningitis pneumococcal
Clinical narrative: Additional information was received that provided patient details, medical history, concomitant therapy, laboratory results, event details including updated and additional events, and a fatal outcome. Information regarding PREVENAR was received from a healthcare professional regarding a 6-month-old female patient who received a third dose on 02-OCT-2008 along with a third dose of ACT-HIB (Aventis), a third dose of TRIPEDIA (Aventis), and third dose of ROTATEQ (Merck & Co Inc) and experienced pneumocococcal bacteremia, Streptococcus pneumoniae meningitis, apnea requiring intubation, multiple infarcts of brain, bradycardia and fluid collection around the brain. The patient has a past history of being a premature baby (36 weeks) (delivered by cesarean section, was in the neonatal intensive care for 2 days). Has a twin. Concomitant therapy included ACT-HIB, TRIPEDIA, ROTATEQ and Zantac. On 20-OCT-2008, the patient was hospitalized after a brief history of several days with respiratory symptoms, low grade fever and decreased appetite and was diagnosed with meningitis pneumococcal and pneumococcal bacteraemia. A blood and cerebrospinal fluid culture was performed showing Streptococcus pneumoniae (serotype not reported). Treatment included KEFLEX, dexamethasone, vancomycin, rifampin, ceftriaxone, Cefotaxime and mannitol. During the course of hospitalization, additional laboratory tests and brain scans were performed which showed multi-focal infarcts with bilateral subdural fluid collections. Initially, the patient's clinical condition stabilized but then was complicated by seizures, apnea requiring intubation, multiple cerebral infarction with subdural effusion and bradycardia. As of 05-Nov-2008, a hospital record indicated the patient's pupils were fixed and dilated. On 14-NOV-2008, it was reported that the patient died. The cause of death was reported as meningitis pneumococcal. Physical examination (results: Weight-17 lb, 6-1/2 inches, height-27-3/4 inches, head circumference 47.5 cm, language/speech, emotional/social, fine/gross motor skills, cognitive thinking, physical growth, developmental milestones - all normal range was done on 02-Oct-2008. On 27-Oct-2008 test results were: chest X-ray (results: Normal chest); red blood cell sedimentation rate (results:72); body temperature (results: 101.8 deg. F.); and culture urine (results: no organisms). On 28-Oct-2008 test results were neutrophil percentage (results: 64%); Band neutrophil percentage (results: 6%); blood culture (results: Strep pneumo); white blood count (results: 5.8); CSF culture (results: pneumococcus (Gram stain stain many G+ cocci in chains)); monocyte percentage (results: 4%); and lymphocyte percentage (results: 26%). White blood cell count (results: 21.9) and scan brain (results: stable extra-axial fluid collections) were done on 31-Oct-2008. Scan brain (results: stable mild diffuse ventriculomegaly, bilateral subdural collections with the left larger than the right, and signal abnormality within the brain as above, compared to MRI performed two days ago) was done on 03-Nov-2008. On 05-Nov-2008 test results were: body temperature (results: 97.9 deg. F.); scan brain (results: multi-focal infarcts, mild ventriculomegaly, and bilateral subdural fluid collections - stable in comparison to a 03-Nov-2008 scan.); white blood cell count (results: 10.0); antibody test (results: Anti - T antibodies - positive); and culture (results: fluid from subdural effusions - negative). No additional information was available at the time of this report.