Age: 13.0
Sex: F
Vaccine: HPV4
Symptoms: Seborrhoeic dermatitis, Staphylococcal skin infection, Syphilis test negative, Ultrasound abdomen abnormal, Weight decreased
Clinical narrative: Information has been received from a registered nurse for the Pregnancy Registry for GARDASIL concerning a 13 year old female with no pertinent medical history and no previous pregnancies. There is a family history of asthma and eczema on the mothers side and adult onset diabetes on the maternal grandmother's side. On 05-DEC-2006, the patient was vaccinated with first dose of GARDASIL (lot # 654540/1262F) 0.5 ml IM. There was no concomitant medication. After the first dose of vaccine, it was determined that the patient was pregnant. She had a physical exam on 05-DEC-2006 and was diagnosed with abdominal fullness. She told the physician at the time of the examination that she currently had her menses. The patient was examined again in January 2007 for a sick visit and was sent for an abdominal ultrasound which showed she was 28 weeks pregnant and all structures within normal limits. Estimated last menstrual period was on approximately 30-JUN-2006 and her estimated date of delivery was 08-MAR-2007. On 30-MAR-2007, the patient gave birth to a healthy baby normal vaginal delivery without any complications. The baby was examined for 1 month check up and was healthy. On 24-APR-2007, the patient was administered her second dose of Gardasil (lot # not reported). No further information was available at the time of reporting. Follow-up information was received from the registered nurse. Information from medical records revealed: A female full term normal infant was born on 30-MAR-2007. Weight 6 pounds and 14 ounces, length 20.5 inches. No congenital anomalies or other complications. Bilirubin 5.4 prior to discharge. Passed the hearing test. Discharge weight 6 pounds 9 ounces. The infant was seen on 03-APR-2007 for new born evaluation. Baby is breast feeding. Has mild jaundice, slight decrease in weight since discharge. Having yellow seedy bowel movements. Coombs test negative. Plan breastfeed more. Evaluated on 04-APR-2007 as follow-up. Excellent weight gain (7 pounds, gained 8 ounces), excellent breast feeding, and less jaundice. Re-evaluated on 11-APR-2007, stooling is fine. Impression was healthy 12 day old infant. Gaining weight. Evaluation on 25-APR-2007, revealed healthy 1 month old with constipation. Evaluation on 29-MAY-2007, revealed healthy 2 month old with seborrheic dermatitis of the scalp. On 29-MAY-2007, the infant was vaccinated with Hib conj vaccine (unspecified carries); PEDIARIX; PREVNAR and ROTATEQ. The infant was evaluated in emergency room on 03-JUN-2007 for a possible bug bite on the left arm and right shoulder. Examination revealed very bad eczema, and a few maculopapules resembling an early varicella rash. The diagnosis was varicella/infection, early abscess. Treatment included amox 125/5, 1 teaspoon po bid. On 04-JUN-2007, the infant was evaluated for large furuncle right shoulder. Pus was extruded and sent for a culture. Infant was switched to AUGMENTIN. Rechecked on 05-JUN-2007. Improved abscess of the shoulder. Continue soaks and AUGMENTIN. Abscess resolving on 11-JUN-2007. On 21-JUN-2007, the infant was hospitalized for erythematous, pustular rash on the scalp and fever. Diagnosis was super infected seborrheic dermatitis with non methicillin-resistant Staphyloccus aureus. She was treated with vancomycin IV and ceftriaxone IV. The patient was discharged on 23-JUN-2007 on AUGMENTIN, bactroban and hydrocortisone topically. Would be followed by dermatology. Was evaluated on 22-JUN-2007 as follow-up. Culture revealed no MRSA. The impression was healthy infant status post hospitalization for infected seborrhea/eczema. Continue with AUGMENTIN, bactroban, and hydrocortisone, AQUAPHOR. Family to bathe with hibiclens. No additional information is expected.