Age: 62.0
Sex: F
Vaccine: DT, TD
Symptoms: Alopecia, Alopecia areata, Audiogram normal, Blood pressure, Dizziness
Clinical narrative: A 62-year-old female received a dose of Decavac (lot number U1927EA; route/site of administration not reported) on 27 March 2007 after experiencing a puncture wound to the right great toe.  The patient reported she also received two "shots" to each side of her toe (medical records indicate the patient received local anesthetic, lidocaine 1%).  The toe was taped with a steri-strip following cleaning with normal saline and exploration.  The patient was sent home with a prescription for Tylenol (two 500 mg tablets to be taken every eight hours as needed for fever or pain).  That night, as the anesthetic wore off, the patient experienced "much" pain.  For the next four weeks she could not put a blanket over her toe because it would hurt.  The patient could not wear closed toe shoes.  On approximately 01 April 2007, the patient started to experience dizziness and blurred vision.  When seen by her primary care physician on 23 April 2007, the patient's blood pressure was 130/100 and she was given blood pressure medicine (not specified).  Three weeks later, her blood pressure was 125/90.  An additional three weeks later, the patient's blood pressure returned to normal.  The patient reported, "The doctor thinks that my body was shocked with the tetanus shot."  The patient also experienced hair loss (onset date not reported).  At the time of this report, hair loss was continuing.  The patient reported that she still does not feel well and continues to experience dizziness and blurred vision at about 11am and 5pm almost every day.  The patient was seen by another physician on 25 September 2007.  The patient reported that this physician "...gave me all kinds of test and he came to the conclusion that the tetanus shot that was given to me was causing the problems that I am experiencing."  Outcome was reported as 'not recovered'.  No additional information was provided at the time of this report.  Follow-up information received on 28 January 2008 from a physician; The reporter saw the patient for the first time on 25 September 2007, six months following the administration of the vaccine.  The reporter did not administer the vaccine and had no information regarding the vaccine or the patient's condition at the time of the injection.  The patient presented to the office with complaints of acute onset of head pressure, lightheadedness, onset of hair loss after receiving tetanus injection at Emergency Room, on 27 March (2007).  The patient felt that since that time, she was not the same.  Her symptoms by the time of the report had somewhat improved.  She developed alopecia areata losing her hair.  She thought that it was related to her tetanus injection.  The patient stated that she had symptoms of dizziness and blurred vision.  She denies any symptoms of true vertigo, however, she felt lightheaded.  On examination (25 September 2007), blood pressure was 122/72, pulse 68.  Audiogram showed evidence of normal hearing bilaterally.  She did have a decreased labyrinthine function on the left side.  The patient possibly had related aseptic encephalitis after the tetanus injection.  Per reporter "from the ear, nose, and throat point of view, there is no treatment necessary at this point.  (25 September 2007)".