Age: 16.0
Sex: F
Vaccine: HPV4, HPV4, HPV4
Symptoms: Headache, Laboratory test normal, Mobility decreased, Muscular weakness, Nuclear magnetic resonance imaging normal
Clinical narrative: Information has been received from a nurse practitioner concerning 16 year old female who was intramuscularly vaccinated with 1st, 2nd and 3rd 0.5 ml doses of GARDASIL (1st lot #658560/1062U, 2nd lot#659439/1267U, 2nd lot#659439/1267U, 3rd lot#660553/0070X) on 24-SEP-2007, 19-NOV-2007 and 20-MAY-2008, respectively. Concomitant therapy included YAZ, MACROBID and "septim (ceptim)". On 11-SEP-2008 the patient experienced urinary tract infection. On 12-SEP-2008 she experienced fever, vomiting and severe back pain. She went to the ER. On 14-SEP-2008 she had headaches, couldn't move her head and was shaky. She was weak and couldn't walk up stairs. A CAT scan was negative. On 25-SEP-2009 she went to a medical center for leg weakness, severe headache, costal vertebral tenderness and photophobia. An MRI done was negative. The patient was treated with morphine drip for her headaches. She was suggested by someone that it could be fibromyalgia. Other lab diagnostics studies included: STD check, vaginal culture, "kidney test", "urinary tract infection (UTI) test" and "e-coli test". All tests done were negative except for the one for her UTI. It was unknown if the patient was ever admitted to a hospital for adverse events. The patient was recovering at the time of reporting. Follow up information was received from a physician who reported that the 16 year old female student with penicillin allergy and post concussion syndrome was intramuscularly vaccinated with 3 doses of GARDASIL (1st dose into right deltoid, 2nd and 3rd doses into the left deltoid). There was no illness at time of vaccination. On 11-SEP-2008, the patient presented in the physician's office with urinary tract infection (UTI), low back pain, blood and leukocytes in urine. She was prescribed MACROBID 100 mg, po, Bid 7. On 12-SEP-2008 she went to emergency room (ER) due to worse syndromes and suggested to perform CT scan. Pyelonephritis was treated with axid ceftin. Nausea, vomiting and fever were treated with pyridine. She also complained of joint pain, could not feel arms and legs and severe headache. CT scan of head was negative on 14-SEP-2008. On 17-SEP-2008 the headache worsened. Spinal tap was performed twice in a hospital and the results were negative. The patient was admitted to the hospital on 21-SEP-2008. Her MRI of head was negative. The patient started to experience unable to walk. In the hospital, the patient was seen by endocrinologist, rheumatologist, and infection disease MD. All test results were negative. On 02-OCT-2008, she was seen in the office. She had bladder infection and still in wheelchair due to unable to walk. On 03-FEB-2009, the physician spoke to patient's mother who indicated the patient was doing better and questioned the relation to GARDASIL. On 05-MAR-2009, the physician spoke to patient's mother who stated the patient was doing much better. Relevant diagnostic tests and  laboratory data included: U/A CPS, CBC, GC/chlomydia, vagionosis DNA probe vaginitis and metabolic panel. All results were negative except UTI. Additional information is not expected. 4/1/09-records received--12/15/08 office notes for C/O unexplained illness, back pain and confusion with symptoms of bladder infection on 9/11/08 after start of antibiotic C/O abdominal pain and not feeling arms and legs, gasping for air and vomiting.  Mild patellotenioral syndrome and possible rheumatologic disease. Now C/O weakness and poor balance and joint pain. 1/2/09-previously seen for recurrent syncope and hyperhidrosis, became ill in September with symptoms of urinary tract infection then devloped severe pain throughout body involving muscles and joints. Tires easily and off balance uses crutches to keep balance. Gait abnormal which may be functional in nature.office visit 3/11/09-C/O sore throat-URI. 5/1/09-records received for DOS 9/23-9/29/08-DC DX: Persistant headaches. S/P pylenoephritis. C/O headache, photophobia, nausea and generalized weakness, lower back pain, epigastric pain and rib pain. Recently on 9/11 had pyelonephristis.