Age: 20.0
Sex: M
Vaccine: FLUN3, HEPAB, MMR, MNQ, PPV
Symptoms: Myalgia, Nerve conduction studies, Oropharyngeal pain, Pain in extremity, Paraesthesia
Clinical narrative: This report to VAERS provides the following narrative: A report has been received from VAERS (Health Authority) concerning a 20 year old, male patient. Patient's relevant history and concomitant disease were not reported. Patient's vaccine given on same day included hepatitis A vaccine, hepatitis B vaccine, MMR vaccine, meningococcal polysaccharide and pneumococcal vaccine. Patient received FLUMIST (intranasal) on 13-May-2009. The total number of 5 vaccines administered was divided between injections in both of his arms (2 and 3). He does not recall any significant local reactions at his vaccination sites. On 28-May-2009 patient reported to sick call for evaluation of URI symptoms. He was treated with MUCINEX, TYLENOL and SUDAFED. He reports multiple sick contacts with similar URI symptoms. On 1-Jun-2009. Diagnosed with bronchitis and prescribed ZITHROMAX. On 2-Jun-2009 patient awoke with tingling, numbness and weakness of his entire body, except for his head and neck. He was seen on sick call for follow up of bronchitis and he was placed on 72 hour quarters. (There was no mention of the numbness or weakness in the clinic note). On 05-Jun-2009, patient returned to sick call with c/o falling to his knees, can't feel legs, feet, shins, hands and fingers. (URI symptoms noted to have significantly improved.) No bowel or bladder symptoms or visual changes. Patient was released to duty 8-Jun-2009. Patient seen in the clinic for body numbness. The following were noted: Gait off balance, ataxia, difficulty with balance- increased concentration required to get dressed as buttons and laces hard to manipulate - unable to feel when he plants his feet down - difficulty writing and with fine manipulative tasks - placed on 48 hour quarters. On 10-Jun-2009. Patient returned to sick call with c/o body numbness up to 10 days and was referred to the ER after PCM consulted with Neurology. On 11-Jun-2009 - Neurologist evaluated patient. HPI noted 10 day history of numbness of all extremities and entire body, with subsequent generalized weakness, gait difficulty, soreness of calves and thighs. Exam revealed slightly diminished strength of UE and LE (4/5), with 3+/5 strength of distal muscle groups. Also on exam, patient was unable to walk a straight line, with abnormal heel walking and diminished DTRs in UEs and absent DTRs in LEs. Diagnosed with Guillain Barre syndrome. Treated with IVIG for 5 days. Transferred to inpatient rehabilitation facility. On 27-Jul-2009 hospital records received. Diagnosis: Guillain Barre Syndrome patient c/o significant numbness in fingers and toes with generalized numbness of body below the neck. Stumbles when he walks. Arthralgias of knees, myalgias in thighs and calves. Easily fatigued, anorexia, URI symptoms such as cough and sore throat, bilateral upper extremity and lower extremity paresthesias, absent DTRs in bilateral lower extremities, decreased DTRs in bilateral upper extremities, weakness of the bilateral upper and lower extremities. Presence of CSF albuminocytologic dissociation (slightly elevated CSF protein with absent pleocytosis). 01-Jun-2009: Labs and diagnostics: CXR, WNL, 11-Jun-2009, EMG/NCD - Summary interpretation: 1. The right median, ulnar, radial, sural and superficial peroneal sensory response were normal. 2. The right median-APB motor response was normal including F-waves and conduction velocity. 3. The right ulnar-ADM motor response has normal distal latency and amplitude. Proximal stimulation above the right elbow showed greater than 50 percentage amplitude decrement as well as slowing of conduction velocity across the elbow. The F-wave latencies were prolonged. 4. The right peroneal-EDB and tibial-AH motor responses were normal including conduction velocities. The right peroneal-ADB F-waves were absent. The right tibial-AH F-waves were normal. 5. Verbal informed consent obtained. Concentric ne. At the time of reporting, the event of Guillain Barre syndrome was ongoing. The reporter considered the event Guillain Barre syndrome to be serious with seriousness criteria of hospitalised and patient also required emergency room.