Age: 1.6
Sex: F
Vaccine: DTAP, HIBV, IPV, MMR, VARCEL
Symptoms: Difficulty in walking, Eczema, Injection site erythema, Injection site pain, Irritability
Clinical narrative: On 7/20/00, the day after receiving vaccines, pt was very irritable and sleepy. She slept nearly all day and then again at night. Her left leg and left arms were sore and red at the injection sites. On 7/21/00, 2 days, post vax, she developed a fever of 102.3F with it's highest at 103.1F. She began to cry for prolonged periods up to 8 hours. She also had intermittent screaming for no apparent reason. Over the next week, she continued to be very irritable and did not want to walk or use the stairs which she previously had done. She wanted to be very still and not moved around. She began to wake in the middle of the night several times, screaming and unable to go back to bed. On 7/29/00, her fever returned between 100F-102F (ax). She would still cry and scream and would arch her back and cry harder as if in a tantrum when anyone would try to comfort her. On 7/30/00, she developed a rash over her entire body. She was taken to the doctor and dx'd with a post vaccine varicella rash. She was put on steroids and Benadryl. On this same day, she stopped talking and her appetite continued to diminish. She stopped responding to loud noises or any sounds other than music from her favorite TV shows. She became glued to the TV set and did not want to do anything else. She seemed physically weak and when she did walk, it was an abnormal gait with 1 shoulder up and her head tilted to the side. She then started to put everything in her mouth, as if she were a baby again. She continued with the eczema, nasal congestion and other symptoms. On 9/23/00, she began to have a fever of 102 (ax), severe diarrhea 4-5 times a day, not eating well (drinking only) and began to pull at her left ear. She was rarely making eye contact. We thought her PE tubes may have been clogged and consulted her ENT. Two days later, still with diarrhea she had abdomen distention and she had open sores on her vaginal and rectal areas. She had brown drainage from her left ear. I insisted on taking her back to the doctor and he ordered stool cultures which were negative and assured me that everything was fine with her ears and that she was not dehydrated. I called again the next day, to the pediatrician's office and was very upset and expressing my concern regarding a change in my daughter's behavior and physical symptoms. The nurse assured me over the phone that the doctor would call me back if he felt it was necessary to see her. The doctor put her on Bactrim and suggested re-inserting the tubes since she was not responding to verbal stimuli, which she had done on 11/1/00. She awoke from anesthesia and was very upset, biting me and thrashing about. From 11/20/00 to 11/27/00, she started with a rash on her cheeks and a fever of 101F. The rash continued and the fever rose to 102.1F. She was lethargic and sleeping most of the time, off and on. She continued to have nasal congestion, no appetite and fever for the next few days. She began to have diarrhea again and was crying constantly for no apparent reason. She was dx'd with left otitis media and virus and placed on Suprax and fluids. On 12/14/00, she had same symptoms and was put on Ominicef and Floxin. She received Prevnar vaccine. One week later, she was unable to balance and was continuously falling. Her left ear had pus and was obstructed. The doctor ordered Garamycin drops and for the next month, several attempts were made to remove the obstruction to no avail. Her behavior continued to deteriorate and had a fit in the doctor's office and it took me 45 minutes to get her out of his office. On 1/11/01, she developed influenza. On 1/17/01, she had another PE insertion. On 2/12/01, she had a respiratory infection. On 2/8/01, she was seen by a pediatric neurologist and dx'd with an encephalopathy. She has seen a geneticist who indicated that she has a mitochondrial disorder which was likely caused by the DTAP, especially the Pertussis. She has seen an allergist and he noted the she demonstrates several allergic type reactions. Doc 198237 states that patient has a permanent metabolic disorder which will require drugs (medication) for the rest of her life. She continues to have sensory problems, auditory processing, speech,language and behavior problems to frustration. She is allergic to numerous foods.But she has improved since the incident. She has started to gain weight and grow again. She is severely behind her development as a result of the event.