Age: 81.0
Sex: F
Vaccine: PNC13
Symptoms: Arthralgia, Arthropathy, Bone marrow oedema, Bursitis, Cyst
Clinical narrative: This is a spontaneous report from a contactable consumer and from a contactable physician. An 81-year-old female consumer received PREVNAR 13 at 0.5 ml single in the left arm at top of his shoulder at near vertical angle, on 16Nov2015 at 09:00. Medical history included ongoing rheumatoid arthritis (diagnosed a long time ago), problem with neck and rotator cuff on right side, fall in 1990, herniated 3 discs but has recovered from vertebrae problems, surgery. Concomitant medications included RITUXAN from 2014 and ongoing (2 in 2 weeks, then 2 more after 6 months, they had extended transfusion time to 3 hours) for rheumatoid arthritis and influenza vaccine in early Oct2015, at 1 DF single, (without any adverse effects). On 16Nov2015, the patient experienced frozen shoulder with pain/hurt at first and right away the pain spread from her neck to her wrist on her left side. She went to the ER and was hospitalized on 20Nov2015. The physician diagnosed it as frozen shoulder and gave her naproxen, hydrocodone and surgery physical therapy meds. The medications worked for pain, but she still could not use her arm or shoulder very much. After exercising and physical therapy she was a little better. On an unknown date the patient experienced also torn rotator cuff and shoulder disabled. On 07Jan2016 MRI of left shoulder joint without contrast (Long-and short-axis fat- and water weighted images) performed: AC arthropathy was mild, subacromial spur. Partial thickness interstitial and bursal surface supraspinatus insertional tendon tear was 1.07 cm. Tear greater than 50% of the tendon depth. Infraspinatus insertion moderately tendinopathic and frayed. Mild to moderate peritendinobursitis. Biceps arcuate segment tendinopathic. Mild glenohumeral arthropathy. Small SLAP type 2A tear. No intraarticular loose body. Supraspinatus muscle was small. Mild fatty atrophy. No soft tissue mass. Cysts and osteoedema within the greater tuberosity. No macrofracture. Final Diagnosis was: Incomplete rotator cuff tear or rupture of left shoulder, not specified as traumatic; impingement syndrome of left shoulder; primary osteoarthritis, left shoulder. Physical therapy (left shoulder push gently) and stretching done. Patient still experiencing frozen shoulder with pain/hurt at first and right away the pain spread from the neck to her wrist on her left side. Outcome of torn rotator cuff and shoulder disabled was unknown. The physician was not provided with the information regarding the adverse events by the patient. The physician was willing to be contacted again by Pfizer on the reported adverse events. Follow-up attempts completed. No further information expected. Follow-up (05Feb2016): New information from the same contactable consumer includes: additional event "torn rotator cuff". Follow up (28Mar2016): New information received from a contactable Physician included: reporter informed regarding the adverse events; reporter further contactability. Follow-up (15Apr2016): New information received from a contactable consumer includes: vaccination date, event onset, seriousness criteria, lab tests, products updated.