Age: 12.0
Sex: F
Vaccine: HPVX, MNQ
Symptoms: Blood product transfusion, Catheter placement, Diet refusal, Dysmenorrhoea, Dysuria
Clinical narrative: Fever, legions growing in mouth and vaginal area, and pain on mucous membranes, including eyes. Onset on early Tuesday morning with these symptoms waking the patient.  By the the next evening spots were breaking out all over.  Took child to emergency room.  Attending Dr. diagnosed her with SJS(Stevens Johnson Syndrome).  She had just had started a clinical trial by her prior pediatrician.  It included Menactra and the HPV vaccine.  He refused to believe anything was really wrong with her when we took her on that Tuesday morning. Thus, we took her to the E.R.  During the stay in the PICU, the dermitologist changed diagnosis to a variation to varicella, because SJS is so rare.  By Friday afternoon it was very apparent it was incorrect and she went back to the first diagnosis of SJS and told us to choose another hospital.  We chose.  They transported her soon after, and hospital knew what to do.  By this time the spots, which had turned to boils at the first hospital were everywhere.  She had not ate in over a week and was in severe pain when urinating from the open boils in her vaginal area.  She was put in the ICU Burn Unit. They first gave her a catheter and treated her body like a burn patient, morphine, and continued with many eye drops to save her eyesight.  She had dermatologists, infectious disease doctors, opthamologists, and others I cannot be sure of.  She was given a feeding tube the next day.  After running their battery of tests, they started the IVIG treatments on Monday.  It was a very stressful, long, and scary two more weeks to see if her body would respond well, or if it had been to late.  Finally, she went to the hospital, for she looked to be recovering.  It took another week or so for her body to be weaned and accept supplement shakes.  Her tongue was disformed and painful from the skin sloghing off.  Plus the muscles had not been used, so talking was difficult.  She lost 20 pounds, but her lips, which had continued to bleed during the time, started to heal, along with her eyes and boils on body.  Emotionally this took a long time to get over.  Her father contracted a near fatal form of pneumonia while there in the hospital with her.    She thankfully has regained eyesight completely and the sore are but little light skin circles on her arm, her lips did lose alot of pigment, and her immune system was weakened.  She becomes sick easily, her period, once it restarted, has been unusual.  First one was comparative to a miscarriage, the amount of blood and onset suddenness.  No she was NOT pregnant.  Then, since this Febuary she has not stopped her period.  Yes, eight months as of this date.  She has seen an endocrinologist, and two OBGYNs.  She has taken progestin, progesterone, estrogen, anmany birth contol pills, but to no avail.. Lo Overol has been the best to date in controlling the severity of the bleeding and pain and hormones.  It defintely isn't perfect, but were hoping for the best.  She has also gained at least 20 Extra pounds before reaction.  1/15/2009 MR received for DOS 1/20-2/10/2007 with D/C DX:  Stevens-Johnson Syndrome. Pt initially presented to local hospital 1/17/07 with swelling of the lips and vaginal lesions.  Transferred to current facility for management of SJS. PE (+) for corneal injection/conjunctivitis, mucosal lesions of the mouth, diffuse maculopapular rash, fever, peeling lips and vaginal lesions. (+) photophobia. Fever and cough 1 week prior to sx. NG tube in place on transfer for decreased po intake 2' to mouth lesions.. Tx with IVIG and Acyclovir. Still developing lesions on 2/6/07. D/C 2/10/07.