Age: 11.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Body temperature increased, Immediate post-injection reaction, Injection site bruising, Injection site cellulitis, Injection site discolouration
Clinical narrative: arm is red with white scattered around the area; not feeling well; Body temperature increased; irritated; hot; redness; Injection site lump; raised lump; Injection site cellulitis; bruise; This case was reported by a consumer via call center representative and described the occurrence of injection site cellulitis in a 11-year-old male patient who received DTPa (Reduced antigen) (Boostrix) (batch number MF9EA, expiry date 1st June 2021) for prophylaxis.   Co-suspect products included Men ACWY-CRM NVS (Menveo) (batch number AMVA112A, expiry date 29th February 2020) for prophylaxis.   On 21st June 2019, the patient received the 1st dose of Boostrix and the 1st dose of Menveo. In June 2019, less than a week after receiving Boostrix and Menveo, the patient experienced injection site cellulitis and injection site bruising. On 21st June 2019, the patient experienced injection site erythema, injection site lump and injection site swelling. On 22nd June 2019, the patient experienced injection site irritation and injection site warmth. On 23rd June 2019, the patient experienced feeling unwell and body temperature increased. On 25th June 2019, the patient experienced injection site discoloration. The patient was treated with cephalexin and ibuprofen (Advil). On an unknown date, the outcome of the injection site cellulitis, injection site bruising, injection site erythema, injection site lump, injection site swelling, injection site irritation, injection site warmth, injection site discoloration, feeling unwell and body temperature increased were not recovered/not resolved.   It was unknown if the reporter considered the injection site cellulitis, injection site erythema, injection site lump, injection site swelling, injection site irritation, injection site warmth, injection site discoloration, feeling unwell and body temperature increased to be related to Boostrix. It was unknown if the reporter considered the injection site cellulitis, injection site bruising, feeling unwell and body temperature increased to be related to Menveo.  Additional information was provided as follows: The patient's mother reported behalf of her son.  The patient received the Boostrix and Menveo vaccine around 4:30 PM or 5:00 PM in pediatric physician's office. Immediately after the vaccination, the patient started to get red on his left arm at the injection site of the Boostrix and there was a red circle the size of a quarter and it was raised with a lump underneath the skin. The following day, 24 hours later, the area became worse and was red, hot and irritated. On Monday which was day three, he awoke and did not feel well and he had a temperature of 105 degrees. He had to come home from camp because he was not feeling well. His pediatrician put him on Cephalexin and Advil because they were not certain if his reactions were related to the vaccination or a bacterial cellulitis. The Mother described her son as being "peaked" or ill. She claimed that her son has had no previous reactions to his vaccinations and has no allergies. The area on his arm is still red today with white scattered around the area and the area measures 10 cm across his left arm. The area was fading a little bit and has shrunk but the center is still red and hot. She also reported that her son received the Menveo vaccine on the same day and on the same left arm, however, he only had a tiny bruise at the Menveo injection site. The reporter consented for follow up.