chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: M
Vaccine: PPV, VARZOS
Symptoms: Injection site erythema, Local swelling, Nausea, Pain in extremity, Pyrexia
Clinical narrative: FEVER, SORE AND SWOLLEN ARM, ERYTHEMA AT SITE, NAUSEA.
Age: 71.0
Sex: M
Vaccine: PPV, VARZOS
Symptoms: Ultrasound scan normal, White blood cell count increased
Clinical narrative: FEVER, SORE AND SWOLLEN ARM, ERYTHEMA AT SITE, NAUSEA.
Age: 63.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site haematoma, Pain in extremity
Clinical narrative: "I thought the nurse put a wad of cotton under my bandaid until I looked at my site and realized I had a 4 cm hematoma.  Hematoma lasted from 10/8/13 until 10/19/13.  My arm is still sore but I didn't have any other symtpoms or difficutly using my arm. I don't bruise easily."
Age: 33.0
Sex: M
Vaccine: FLUX
Symptoms: Chills, Pain, Pyrexia
Clinical narrative: Chills, fever, severe whole body aches that are ongoing after three days. Concerned that this may be Guillain-Barré Syndrome as I have never had this reaction to the flu vaccine before. Also the steroid QVAR may be impacting my body's ability to manage its immune response.
Age: 77.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site mass, Injection site swelling
Clinical narrative: Red lump to injection site (Left Deltoid) with swelling, redness to elbow.
Age: 65.0
Sex: F
Vaccine: FLU3
Symptoms: Blood pressure increased, Feeling abnormal, Heart rate increased
Clinical narrative: Patient had increased pulse and blood pressure 10 minutes after receiving the vaccine.
Age: 39.0
Sex: M
Vaccine: FLUX
Symptoms: Asthenia, Joint range of motion decreased, Musculoskeletal pain, Pain, Pain in extremity
Clinical narrative: Pain in shoulder, radiating down arm. Limited ROM, painful ROM and weakness in still 2 weeks after shot.
Age: 9.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Pruritus
Clinical narrative: The patient's arm quickly turned red and began to itch.  The next day she was still red and itchy, and the pharmacist then recommended Benadryl for the itchiness.
Age: 51.0
Sex: F
Vaccine: FLUX
Symptoms: Cough, Fatigue, Headache, Influenza like illness, Pyrexia
Clinical narrative: Felt very tired and had runny nose.  This progressed into headache, cough and flu like symptoms.  Fever on 10/23/13 was 101.  Routine measures such as aspirin and nasal spray and rest worked fine.
Age: 51.0
Sex: F
Vaccine: FLUX
Symptoms: Rhinorrhoea
Clinical narrative: Felt very tired and had runny nose.  This progressed into headache, cough and flu like symptoms.  Fever on 10/23/13 was 101.  Routine measures such as aspirin and nasal spray and rest worked fine.
Age: 19.0
Sex: F
Vaccine: FLU3
Symptoms: Blood test normal, Computerised tomogram normal, Convulsion
Clinical narrative: Seizure that lasted for 30 seconds. Taken to hospital CAT scan and blood work were all showing good signs.
Age: 58.0
Sex: F
Vaccine: FLUX
Symptoms: Arthralgia, Chills, Muscle spasms, Pyrexia
Clinical narrative: All joints in body extremely sore, all muscle groups from neck to feets seizing and cramping, alternating fever/chills.
Age: 34.0
Sex: F
Vaccine: FLUX
Symptoms: Heart rate increased, Local swelling, Pain in extremity, Pyrexia
Clinical narrative: Shooting pain in arm, swelling of arm, fever, increased heart rate.
Age: 65.0
Sex: M
Vaccine: FLUX
Symptoms: Cough, Headache, Myalgia, Oropharyngeal pain, Rhinorrhoea
Clinical narrative: Runny nose, sore throat, coughing, muscle pain, headaches.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Arthralgia, Asthenia, Chills, Fatigue, Heart rate increased
Clinical narrative: Chills, fever (101 F), aches, nausea, harder and faster-than-normal heart rate, ~90 bps (normal for me is about 60 bps). Fever subsided by about 10:00 am the next day, but for the next day (10/23) I was extremely weak, tired and joints aching far more than normal for the next 24 hours.  Two days later, I am tired and shaky.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Nausea, Pain, Palpitations, Pyrexia, Tremor
Clinical narrative: Chills, fever (101 F), aches, nausea, harder and faster-than-normal heart rate, ~90 bps (normal for me is about 60 bps). Fever subsided by about 10:00 am the next day, but for the next day (10/23) I was extremely weak, tired and joints aching far more than normal for the next 24 hours.  Two days later, I am tired and shaky.
Age: 51.0
Sex: F
Vaccine: FLUX
Symptoms: Contusion, Erythema, Fatigue, Pruritus, Swelling
Clinical narrative: ERYTHEMA, ITCHING, BRUISING, SLIGHT SWELLING, FATIGUE.
Age: 69.0
Sex: F
Vaccine: FLU3
Symptoms: Cough, Dyspnoea, Fatigue, Lacrimation increased, Oropharyngeal pain
Clinical narrative: Cough, sore throat, difficulty breathing, watery eyes, achiness, feverish, tired.
Age: 69.0
Sex: F
Vaccine: FLU3
Symptoms: Pain, Pyrexia
Clinical narrative: Cough, sore throat, difficulty breathing, watery eyes, achiness, feverish, tired.
Age: 70.0
Sex: M
Vaccine: FLU3
Symptoms: Arthralgia, Chest X-ray, Differential white blood cell count, Full blood count, Hypoaesthesia
Clinical narrative: Complete numbness of right middle finger and partial numbness of pointer and ring fingers. By the next day, this had progressed to the left hand with complete numbness of the left middle finger and partial numbness of the pointer and ring fingers. By the next day, experiencing extreme pain in both shoulders, elbows, wrists and hands along with the numbness in fingers on both hands.
Age: 70.0
Sex: M
Vaccine: FLU3
Symptoms: Liver function test, Metabolic function test, Musculoskeletal pain, Pain in extremity, Red blood cell sedimentation rate
Clinical narrative: Complete numbness of right middle finger and partial numbness of pointer and ring fingers. By the next day, this had progressed to the left hand with complete numbness of the left middle finger and partial numbness of the pointer and ring fingers. By the next day, experiencing extreme pain in both shoulders, elbows, wrists and hands along with the numbness in fingers on both hands.
Age: 70.0
Sex: M
Vaccine: FLU3
Symptoms: Thyroid function test, Urine analysis
Clinical narrative: Complete numbness of right middle finger and partial numbness of pointer and ring fingers. By the next day, this had progressed to the left hand with complete numbness of the left middle finger and partial numbness of the pointer and ring fingers. By the next day, experiencing extreme pain in both shoulders, elbows, wrists and hands along with the numbness in fingers on both hands.
Age: 62.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Induration, Skin warm, Tenderness
Clinical narrative: Large local area of erythema with associated warmth and tenderness.  The area is firm to pressure.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Asthenia, Dizziness, Eye swelling, Palatal oedema, Pharyngeal oedema
Clinical narrative: Swelling in palate. Took an Allegra. Eyes, throat started swelling, bowel movements and vomiting. Dizzy and weak. Throat swollen. By 11 PM, swelling and symptoms totally resolved.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Vomiting
Clinical narrative: Swelling in palate. Took an Allegra. Eyes, throat started swelling, bowel movements and vomiting. Dizzy and weak. Throat swollen. By 11 PM, swelling and symptoms totally resolved.
Age: 56.0
Sex: F
Vaccine: FLUX
Symptoms: Hypoaesthesia, Paraesthesia
Clinical narrative: TINGLING, NUMBNESS IN THE LEFT HAND AFTER A FLU SHOT.
Age: 49.0
Sex: F
Vaccine: FLU4
Symptoms: Hypoaesthesia, Injection site erythema, Injection site swelling
Clinical narrative: Localized swelling and erythema at injection site. Ee complains of feeling numbness in extremities; speficially left hand and left foot.
Age: 26.0
Sex: F
Vaccine: FLU3
Symptoms: Blood pressure increased, Dry mouth, Flushing, Throat tightness
Clinical narrative: At 11:46 am the client stated she had a flush feeling and dry mouth. BP149/111m HR130 RR22. Client stated her throat felt like it was closing. 911 called and administration of 0.5ml of Epinephrine given subcutaneously. EMS arrived at 12:04pm and Benadryl 50mg given by EMS, EMS assessed patient, EMS left after 15minutes, patient refused to go to emergency room. Vital Signs continued by Nursing staff at clinic, 132/80BP, HR106, RR22. Patient left clinic and returned to work. Patient was called 6 hours after incident for follow up and was feeling fine. No residual symptoms.
Age: 55.0
Sex: F
Vaccine: FLU3
Symptoms: Asthma, Condition aggravated, Cough, Fatigue, Feeling abnormal
Clinical narrative: My explanation of issues after getting the flu shot this year on October 4, 2013. I was given my flu shot on Friday, October 4th in the afternoon. By Saturday I was feeling a little under the weather. By Sunday afternoon it was hitting me full force. By Monday morning I could hardly get out of bed. I went to the urgent care. She put me on Levaquin and Prometh/Cod for cough. She also put me off of work for a week. I still was not ready (feeling well enough) to go back to work but my FMLA papers were only for a week. I have continued with the severe cough and had an appointment with Dr. on Monday, October 21st. In our conversation he said that the flu shot did exacerbated my system into a full asthma attack. Dr. put me on Prednisone and more cough syrup. This is my third week of this after missing a full week of work and 2 trips the doctor and 2 rounds of medication.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Activities of daily living impaired, Fatigue, Headache, Malaise, Pain
Clinical narrative: 11:00am- 1hr after vaccine- Headache. Noon- achy, tired, general malaise, went home. 1:00pm & after, fever no higher then 100F, vomiting x 1. Out of work.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Pyrexia, Vomiting
Clinical narrative: 11:00am- 1hr after vaccine- Headache. Noon- achy, tired, general malaise, went home. 1:00pm & after, fever no higher then 100F, vomiting x 1. Out of work.
Age: 29.0
Sex: M
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: Redness, induration and warmth at injection site.
Age: 38.0
Sex: F
Vaccine: FLU3
Symptoms: Headache, Injection site erythema, Injection site swelling, Injection site warmth, Pain
Clinical narrative: Swelling, redness, warmth at injection site, headache, general body ache.
Age: 55.0
Sex: F
Vaccine: FLU3, HEP, PPV
Symptoms: Erythema, Induration, Local swelling, Pain in extremity
Clinical narrative: (R) arm painful, swollen, red, hard to touch. Appx. 30 minutes after vaccine admin. Pt advised to use acetaminophen or ibuprofen, and ice.
Age: 55.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Pain in extremity
Clinical narrative: Pain radiating up and down arm, "bit red patches" on shoulder, axilla. Unable to come to clinic for evaluation and tx.
Age: 80.0
Sex: M
Vaccine: FLU3
Symptoms: Blister, Erythema, Skin warm
Clinical narrative: Patient left upper arm and shoulder warm, pink, and blisters present. Vital signs stable. No temp noted. Family encouraged to use TYLENOL and ice to area. MD order KEFLEX x 5 days.
Age: 71.0
Sex: F
Vaccine: VARZOS
Symptoms: Cellulitis
Clinical narrative: Patient was given vaccination (ZOSTAVAX) on 10-12-2013 at pharmacy. Patient developed cellulitis and received antibiotic injections (in MD office) and was prescribed oral antibiotic (given oral antibiotic 10-18-2013). Patient went to MD on October 15th, 16th, 17th, and 18th.
Age: 21.0
Sex: F
Vaccine: FLU3
Symptoms: Computerised tomogram head, Convulsion, Nuclear magnetic resonance imaging brain
Clinical narrative: 6 discrete seizures 10/16/13 - 10/17/13; CT scan and MRI of brain at Med. Ctr. Started on KEPPRA 500mg BID and Neuro referral done for follow-up.
Age: 79.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Pt presented to office 10-11-13 to show SN swelling and reddened area on (L) deltoid had a pink-reddish area that measured 16 cm length by 10 cm width which extended down and medial to injection site. Warm and tender to touch. Circumference of arm .6 cm longer than (R) arm.
Age: 1.11
Sex: M
Vaccine: HEPA, MMR
Symptoms: Rash, Rash morbilliform
Clinical narrative: MMR given on 06/05/2013, rash appeared on 06/18/2013. No response to antihistamines. Grandma called office concerned that rash looked like measles although patient remained afebrile. Rash resolved by 2 week f/u.
Age: 84.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Injection site mass
Clinical narrative: Patient states had Zostavax and developed lump in L arm at site about 2 mo later. Having large growth removed by dermatologist/plastic surgeon today. I called CDC/Merck and given case # 1-9146839769.
Age: 84.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Basal cell carcinoma, Biopsy skin abnormal, Injection site mass, Skin neoplasm excision
Clinical narrative: Patient states had Zostavax and developed lump in L arm at site about 2 mo later. Having large growth removed by dermatologist/plastic surgeon today. I called CDC/Merck and given case # 1-9146839769.
Sex: M
Vaccine: FLU3, PPV
Symptoms: Insomnia, Local swelling, Pain in extremity
Clinical narrative: Left arm has swollen and become painful. Pt was unable to sleep the evening of shot (10/23/13). Pt seems to be doing better (AM of 10/24/13) - given a steroid shot by Dr.
Age: 82.0
Sex: F
Vaccine: FLU3
Symptoms: Mobility decreased
Clinical narrative: Got flu shot 10/22/13 (Tuesday). No pain at time. 10-23-13 - woke up and could not move arm. 10-24-13 - came to pharmacy to report. Pt told to see doctor.
Age: 43.0
Sex: F
Vaccine: TDAP
Symptoms: Cellulitis, Injection site abscess, Lymphadenopathy, Rash, Urticaria
Clinical narrative: Rash and hives to face and neck, cellulitis, abscess at site (L) deltoid, enlarged lymph nodes (L) neck and axilla.
Age: 72.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Fatigue, Injection site erythema, Pyrexia
Clinical narrative: Had the "FLUVIRIN" flu vaccine and had a reaction. Redness at site, fever x 4 days, chills, fatigue.
Age: 65.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Cellulitis, Pyrexia
Clinical narrative: Patient received pneumococcal vaccine polyvalent and flu vaccine on 10/21/13. Pt returned to clinic 10/23/13 with cellulitis left arm and fever. Pt treated with Keflex.
Age: 73.0
Sex: U
Vaccine: PPV
Symptoms: Injection site swelling, Local reaction
Clinical narrative: Swelling at site injection and from shoulder to elbow (ie, severe local reaction).
Age: 63.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Chills, Headache, Injection site erythema, Injection site oedema, Injection site pain
Clinical narrative: Fever 102F, chills, nausea, pain with edema and redness in left deltoid at injection site area, severe headache.
Age: 63.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Injection site reaction, Laboratory test, Nausea, Pain, Pain in extremity
Clinical narrative: Fever 102F, chills, nausea, pain with edema and redness in left deltoid at injection site area, severe headache.
Age: 63.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Pyrexia, Rash erythematous
Clinical narrative: Fever 102F, chills, nausea, pain with edema and redness in left deltoid at injection site area, severe headache.
Age: 51.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site pain, Injection site swelling, Local swelling
Clinical narrative: Swelling and pain at the site (left deltoid), swelling in the left axilla. Persisted x 3 weeks before resolving slowly.
Age: 45.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Cough, Fatigue, Malaise, Respiratory tract congestion
Clinical narrative: Rapid onset of extreme fatigue, malaise, chills, chest congestion, and cough. Symptoms are continuing now at day 7 (today, 10/24/2013). Over the counter medications only.
Age: 29.0
Sex: F
Vaccine: FLUX
Symptoms: Fatigue, Restlessness
Clinical narrative: From the evening I received my shot on 10/23/2013, I felt tired and restless. I went to bed at my usual time about 10pm. I was not able to wake from my sleep on 10/24/2013, not being able to get up at 5:45am on my usual Tuesday and Thursday schedule for class. I finally was forced to wake up by my partner at 8am. I then fell back to sleep at about 10am and woke up at 1:15pm. It is right now 2pm and I feel tired and exhausted still even after sleeping for about 3 hours.
Age: 79.0
Sex: M
Vaccine: FLU3
Symptoms: Aggression, Agitation, Aphasia, Barium swallow abnormal, CSF test normal
Clinical narrative: Patient received influenza vaccine on 10/08/2013. Patient was at home on 10/16/2013, where patient suddenly started to experience a left frontal headache, expressive aphasia, unsteady gait. The patient immediately presented to the ED with his wife where the CT of his head showed no acute intracranial findings. His initial NIHSS score was 4, and he was initiated on the stroke protocol, was administered TPA, and got admitted to the floor. During his MRI of his head, he became very agitated where he had to receive lorazepam and dexmedetomidine. His MRI had no evidence to suggest acute ischemia, and his EEG was unremarkable. In addition to this, he failed his swallow evaluation. During his stay here, he continued to have expressive dysphasia along with "delirium" and combativeness. Many consults and evaluations were done and there has not been a cause to his acute mental changes. ID was consulted and there were no significant infectious findings, including a normal CSF sample.  In addition to this, there has been no evidence of a cerebral vasculitis. The patient was discharged on 10/24/13 with residual dysphasia, however he has improved and will follow up with neurology outpatient. The neuorology intensivist suspects the encephalopathy to be possibly due to influenza vaccine vs. paraneoplastic syndrom as the patient has a stromal cell GI maliganancy history.
Age: 79.0
Sex: M
Vaccine: FLU3
Symptoms: Computerised tomogram head normal, Delirium, Electroencephalogram normal, Encephalopathy, Gait disturbance
Clinical narrative: Patient received influenza vaccine on 10/08/2013. Patient was at home on 10/16/2013, where patient suddenly started to experience a left frontal headache, expressive aphasia, unsteady gait. The patient immediately presented to the ED with his wife where the CT of his head showed no acute intracranial findings. His initial NIHSS score was 4, and he was initiated on the stroke protocol, was administered TPA, and got admitted to the floor. During his MRI of his head, he became very agitated where he had to receive lorazepam and dexmedetomidine. His MRI had no evidence to suggest acute ischemia, and his EEG was unremarkable. In addition to this, he failed his swallow evaluation. During his stay here, he continued to have expressive dysphasia along with "delirium" and combativeness. Many consults and evaluations were done and there has not been a cause to his acute mental changes. ID was consulted and there were no significant infectious findings, including a normal CSF sample.  In addition to this, there has been no evidence of a cerebral vasculitis. The patient was discharged on 10/24/13 with residual dysphasia, however he has improved and will follow up with neurology outpatient. The neuorology intensivist suspects the encephalopathy to be possibly due to influenza vaccine vs. paraneoplastic syndrom as the patient has a stromal cell GI maliganancy history.
Age: 79.0
Sex: M
Vaccine: FLU3
Symptoms: Headache, Mental status changes, Nuclear magnetic resonance imaging brain normal, Paraneoplastic syndrome
Clinical narrative: Patient received influenza vaccine on 10/08/2013. Patient was at home on 10/16/2013, where patient suddenly started to experience a left frontal headache, expressive aphasia, unsteady gait. The patient immediately presented to the ED with his wife where the CT of his head showed no acute intracranial findings. His initial NIHSS score was 4, and he was initiated on the stroke protocol, was administered TPA, and got admitted to the floor. During his MRI of his head, he became very agitated where he had to receive lorazepam and dexmedetomidine. His MRI had no evidence to suggest acute ischemia, and his EEG was unremarkable. In addition to this, he failed his swallow evaluation. During his stay here, he continued to have expressive dysphasia along with "delirium" and combativeness. Many consults and evaluations were done and there has not been a cause to his acute mental changes. ID was consulted and there were no significant infectious findings, including a normal CSF sample.  In addition to this, there has been no evidence of a cerebral vasculitis. The patient was discharged on 10/24/13 with residual dysphasia, however he has improved and will follow up with neurology outpatient. The neuorology intensivist suspects the encephalopathy to be possibly due to influenza vaccine vs. paraneoplastic syndrom as the patient has a stromal cell GI maliganancy history.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Headache, Muscular weakness, Nausea, Posture abnormal, Vomiting
Clinical narrative: Severe headache, nausea, vomiting, muscle weakness. Stated she couldn't hold her head up, taken to ER.
Age: 54.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Joint swelling, Local swelling, Mobility decreased, Musculoskeletal pain
Clinical narrative: First my shoulder/arm was very swollen and sore.  Then later that evening the area became very red fingering out toward my chest.  The pain was so bad I could not move my arm.  The next day the physician I work for wanted to prescibe an oral antibiotic for me but because of a previous cdiff complication, I could not take one.  He prescribed Bactroban.  This is now 10-24-13 and the area is better but still tender to the touch and aches.
Age: 54.0
Sex: F
Vaccine: PPV
Symptoms: Pain, Pain in extremity, Tenderness
Clinical narrative: First my shoulder/arm was very swollen and sore.  Then later that evening the area became very red fingering out toward my chest.  The pain was so bad I could not move my arm.  The next day the physician I work for wanted to prescibe an oral antibiotic for me but because of a previous cdiff complication, I could not take one.  He prescribed Bactroban.  This is now 10-24-13 and the area is better but still tender to the touch and aches.
Age: 32.0
Sex: M
Vaccine: FLU3
Symptoms: Body temperature increased, Dysgeusia, Hypoaesthesia oral, Tongue disorder
Clinical narrative: Noticed a metallic taste over entire surface of tongue, and numbness at back of tongue along right lateral edge, and underside on right of tongue, as well as inner right gum line. Injection given on left deltoid at 12:00PM. S/S intensifying over four following hours. Temperature elevated at 3:45 PM at 98.8 degrees normal temp is low 97 degrees.
Age: 66.0
Sex: F
Vaccine: FLU3, FLU3, FLU3
Symptoms: Balance disorder, Dysstasia
Clinical narrative: Imbalance sensation when walking, standing.
Age: 66.0
Sex: F
Vaccine: FLU3, FLU3, FLU3
Symptoms: Balance disorder
Clinical narrative: Imbalance sensation when walking, standing.
Age: 66.0
Sex: F
Vaccine: FLU3, FLU3, FLU3
Symptoms: Balance disorder, Nuclear magnetic resonance imaging brain
Clinical narrative: Imbalance sensation when walking, standing.
Age: 17.0
Sex: F
Vaccine: HEP, MNQ, VARCEL
Symptoms: Asthenia, Hypoaesthesia, Speech disorder, VIIth nerve paralysis
Clinical narrative: Patient presented to ED with numb and paralyzed right side of the face. Little hard to talk. Focal weakness during neuroreview of systems. Patient has a history of Bell's Palsy with the previous incident on 09/04/2010.
Age: 11.0
Sex: F
Vaccine: MNQ, TDAP
Symptoms: Erythema, Local swelling
Clinical narrative: Redness and swollen to left arm. Mom was concerned and took her to emergency room. Patient was prescribed antibiotic.
Age: 75.0
Sex: M
Vaccine: FLU3
Symptoms: Abasia, Arthralgia, Communication disorder, Dysstasia, Fall
Clinical narrative: He initially began with numbness and pain in his hands around 6pm and it progressed to his arms by the following day. By 10/11/2013 he began with hip pain that continued to descend to feet throughout the day.  By Saturday morning around 7 am on 10/12/2013 he began with numbness.  He presented to hospital that am.  By the time he was discharged around 2pm he could no longer ambulate.  This progressed as the night went on.  His blood pressure was high at hosp. Like 200/90.  He had MRI completed and Xrays at this hospital.  By 3pm the decision was made to take him to yet another emergency room . He went to stand and began falling backwards, but was caught.  Around 630 pm on sat 10/12 he was taken into another hospital.  He could not stand, his pressure was 70/40's, he was not mentating appropriately.  He was triaged immediately when he began shaking and unable to communicate.  See hospital records for details that follow.  He was admitted to hospital at this point.  By Sunday around 6pm a lumbar puncture performed to obtain spinal fluid.  by Monday am, a confirmed diagnosis was given of Guillain Barre.  Plan then was to begin IVIG treatments x 5.  This was performed and patient was eventually transferred to rehab by Sat 10/19.
Age: 75.0
Sex: M
Vaccine: FLU3
Symptoms: Guillain-Barre syndrome, Hypertension, Hypoaesthesia, Immunoglobulin therapy, Lumbar puncture
Clinical narrative: He initially began with numbness and pain in his hands around 6pm and it progressed to his arms by the following day. By 10/11/2013 he began with hip pain that continued to descend to feet throughout the day.  By Saturday morning around 7 am on 10/12/2013 he began with numbness.  He presented to hospital that am.  By the time he was discharged around 2pm he could no longer ambulate.  This progressed as the night went on.  His blood pressure was high at hosp. Like 200/90.  He had MRI completed and Xrays at this hospital.  By 3pm the decision was made to take him to yet another emergency room . He went to stand and began falling backwards, but was caught.  Around 630 pm on sat 10/12 he was taken into another hospital.  He could not stand, his pressure was 70/40's, he was not mentating appropriately.  He was triaged immediately when he began shaking and unable to communicate.  See hospital records for details that follow.  He was admitted to hospital at this point.  By Sunday around 6pm a lumbar puncture performed to obtain spinal fluid.  by Monday am, a confirmed diagnosis was given of Guillain Barre.  Plan then was to begin IVIG treatments x 5.  This was performed and patient was eventually transferred to rehab by Sat 10/19.
Age: 75.0
Sex: M
Vaccine: FLU3
Symptoms: Nuclear magnetic resonance imaging, Pain in extremity, Paraesthesia, Paralysis, Tremor
Clinical narrative: He initially began with numbness and pain in his hands around 6pm and it progressed to his arms by the following day. By 10/11/2013 he began with hip pain that continued to descend to feet throughout the day.  By Saturday morning around 7 am on 10/12/2013 he began with numbness.  He presented to hospital that am.  By the time he was discharged around 2pm he could no longer ambulate.  This progressed as the night went on.  His blood pressure was high at hosp. Like 200/90.  He had MRI completed and Xrays at this hospital.  By 3pm the decision was made to take him to yet another emergency room . He went to stand and began falling backwards, but was caught.  Around 630 pm on sat 10/12 he was taken into another hospital.  He could not stand, his pressure was 70/40's, he was not mentating appropriately.  He was triaged immediately when he began shaking and unable to communicate.  See hospital records for details that follow.  He was admitted to hospital at this point.  By Sunday around 6pm a lumbar puncture performed to obtain spinal fluid.  by Monday am, a confirmed diagnosis was given of Guillain Barre.  Plan then was to begin IVIG treatments x 5.  This was performed and patient was eventually transferred to rehab by Sat 10/19.
Age: 75.0
Sex: M
Vaccine: FLU3
Symptoms: X-ray
Clinical narrative: He initially began with numbness and pain in his hands around 6pm and it progressed to his arms by the following day. By 10/11/2013 he began with hip pain that continued to descend to feet throughout the day.  By Saturday morning around 7 am on 10/12/2013 he began with numbness.  He presented to hospital that am.  By the time he was discharged around 2pm he could no longer ambulate.  This progressed as the night went on.  His blood pressure was high at hosp. Like 200/90.  He had MRI completed and Xrays at this hospital.  By 3pm the decision was made to take him to yet another emergency room . He went to stand and began falling backwards, but was caught.  Around 630 pm on sat 10/12 he was taken into another hospital.  He could not stand, his pressure was 70/40's, he was not mentating appropriately.  He was triaged immediately when he began shaking and unable to communicate.  See hospital records for details that follow.  He was admitted to hospital at this point.  By Sunday around 6pm a lumbar puncture performed to obtain spinal fluid.  by Monday am, a confirmed diagnosis was given of Guillain Barre.  Plan then was to begin IVIG treatments x 5.  This was performed and patient was eventually transferred to rehab by Sat 10/19.
Age: 57.0
Sex: M
Vaccine: FLUX
Symptoms: Arthralgia, Headache, Muscular weakness, Myalgia, Vertigo
Clinical narrative: Headache, vertigo, muscle ache/weakness, joint pain hands/knees two day duration at this time of texting.
Age: 64.0
Sex: F
Vaccine: FLU3
Symptoms: Insomnia, Musculoskeletal pain
Clinical narrative: Shoulder pain, can't sleep due to pain.
Age: 25.0
Sex: M
Vaccine: DPP
Symptoms: Chills, Headache, Pain, Pyrexia
Clinical narrative: Fever of 102.7. Body aches, headache, and chills.
Age: 49.0
Sex: F
Vaccine: FLUX
Symptoms: Activities of daily living impaired, Asthenia, Bronchitis, Cough, Dyspnoea
Clinical narrative: Fever (101-102 degrees) developed after 12 hours receiving flu-shot associated with Headaches and achiness and pain in the muscles. Treated with Motrin and Advil. On 10/18/2013, 40+ hours after the flu-shot, felt weak with runny nose and sore throat. 10/19/2013, sore throat worsened and dry cough started. 10/21/2013, fever's back and cough worsened. 10/22/2013, trouble to breath with severe cough. Unable to work, visited doctor's office and diagnosed with acute  bronchitis. Put on the following meds: Levofloxacin; Naproxen; AND Hydroxyzine. 10/23/2013, severe hive developed all over body, added Benadryl and switched to Azithromycin. 10/24/2013, hives remains, cough worsening.
Age: 49.0
Sex: F
Vaccine: FLUX
Symptoms: Headache, Myalgia, Oropharyngeal pain, Pyrexia, Rhinorrhoea
Clinical narrative: Fever (101-102 degrees) developed after 12 hours receiving flu-shot associated with Headaches and achiness and pain in the muscles. Treated with Motrin and Advil. On 10/18/2013, 40+ hours after the flu-shot, felt weak with runny nose and sore throat. 10/19/2013, sore throat worsened and dry cough started. 10/21/2013, fever's back and cough worsened. 10/22/2013, trouble to breath with severe cough. Unable to work, visited doctor's office and diagnosed with acute  bronchitis. Put on the following meds: Levofloxacin; Naproxen; AND Hydroxyzine. 10/23/2013, severe hive developed all over body, added Benadryl and switched to Azithromycin. 10/24/2013, hives remains, cough worsening.
Age: 49.0
Sex: F
Vaccine: FLUX
Symptoms: Urticaria
Clinical narrative: Fever (101-102 degrees) developed after 12 hours receiving flu-shot associated with Headaches and achiness and pain in the muscles. Treated with Motrin and Advil. On 10/18/2013, 40+ hours after the flu-shot, felt weak with runny nose and sore throat. 10/19/2013, sore throat worsened and dry cough started. 10/21/2013, fever's back and cough worsened. 10/22/2013, trouble to breath with severe cough. Unable to work, visited doctor's office and diagnosed with acute  bronchitis. Put on the following meds: Levofloxacin; Naproxen; AND Hydroxyzine. 10/23/2013, severe hive developed all over body, added Benadryl and switched to Azithromycin. 10/24/2013, hives remains, cough worsening.
Age: 27.0
Sex: F
Vaccine: FLU3
Symptoms: Cough, Eye discharge, Eye pain, Malaise, Migraine
Clinical narrative: Oculo-Respiratory Syndrome.  Bright red painful eyes, green discharge from eyes, fever, malaise, shakes, migraine, cough, sore throat, body aches, mild nausea.
Age: 27.0
Sex: F
Vaccine: FLU3
Symptoms: Nausea, Oculorespiratory syndrome, Oropharyngeal pain, Pain, Pyrexia
Clinical narrative: Oculo-Respiratory Syndrome.  Bright red painful eyes, green discharge from eyes, fever, malaise, shakes, migraine, cough, sore throat, body aches, mild nausea.
Age: 27.0
Sex: F
Vaccine: FLU3
Symptoms: Tremor
Clinical narrative: Oculo-Respiratory Syndrome.  Bright red painful eyes, green discharge from eyes, fever, malaise, shakes, migraine, cough, sore throat, body aches, mild nausea.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Induration, Local swelling, Pain, Pain in extremity
Clinical narrative: Woke up & arm was swelling & hard, red, over the next day the area was 5" long, 3" wide and 1" thick.  It hurt, itched, and it was painful to move my arm except slowly.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Pruritus
Clinical narrative: Woke up & arm was swelling & hard, red, over the next day the area was 5" long, 3" wide and 1" thick.  It hurt, itched, and it was painful to move my arm except slowly.
Age: 69.0
Sex: F
Vaccine: PPV
Symptoms: Urticaria
Clinical narrative: Pt broke out into hives that started in vaccinated arm and spread to chest.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Immediate post-injection reaction, Influenza like illness
Clinical narrative: Flu like symptoms came on immediately lasted for three days.   Fairly moderate symptoms.     Afluria
Age: 33.0
Sex: F
Vaccine: FLUX
Symptoms: Erythema, Pain, Skin warm
Clinical narrative: Red area (4in in diameter), very sore to touch, warm feeling.
Age: 70.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Influenza like illness, Injection site erythema, Injection site swelling
Clinical narrative: Patient received both FluzoneHD and Pneumovax23 vaccinations on same day.  She began to feel flu-like symptoms that evening, which lasted about ten days.  She also experienced a red/swollen upper arm where the vaccines were administered.  She was unable to recall around which injection site that the reaction started.
Age: 45.0
Sex: F
Vaccine: FLUX
Symptoms: Injection site reaction, Myalgia
Clinical narrative: Extreme muscle pain in shoulder at site of injection - lasting 4 weeks and counting.
Age: 69.0
Sex: M
Vaccine: FLU3
Symptoms: Angioedema, Chest discomfort, Dyspnoea, Rash
Clinical narrative: Angioedema, rash, breathing problems, tightness of chest.
Age: 83.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Cellulitis, Computerised tomogram abnormal, Culture, Diagnostic aspiration, Local swelling
Clinical narrative: By 9:00 AM the day after the vaccine was administered (Friday, 10/18/2013) by my primary care physician, my right arm began to be swell and was painful.  By Tuesday, 10/22/2013, the swelling and pain became very severe.  I called my physician to advise him of these adverse events and he instructed me to immediately go to the ER room of my local hospital.  The ER doctors took my vital signs, performed a CT scan of my right arm, and then performed an aspiration of the fluid in my right arm, guided by a second CT scan. The purpose of aspiration was to culture the fluid and to send it to a lab to determine organism/bacteria type.  The results of the culture would not be known until Thursday, 10/24/2013. In the interim, I was admitted as a patient on Tuesday night (10/22/2013) at approximately 9:00 PM and began a regimen of Azactam, an antibiotic, intravenously at the rate of 1 gram every 8 hours through Thursday, 10/24/2013, by the infectious disease doctor on call at the hospital. On Thursday morning, 10/24/2013, the results of the culture mentioned above were received by the hospital and the diagnosis was cellulitis. I was discharged by the infectious disease doctor on Thursday, 10/24/13 at 1:00 PM and was prescribed an oral antibiotic (Avelox  400 mg) by him to be taken at the rate of one tablet per day for 5 days. The discharge orders indicated that I was to follow-up with my primary physician, within one week of Thursday, 10/24/13.
Age: 83.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Pain in extremity
Clinical narrative: By 9:00 AM the day after the vaccine was administered (Friday, 10/18/2013) by my primary care physician, my right arm began to be swell and was painful.  By Tuesday, 10/22/2013, the swelling and pain became very severe.  I called my physician to advise him of these adverse events and he instructed me to immediately go to the ER room of my local hospital.  The ER doctors took my vital signs, performed a CT scan of my right arm, and then performed an aspiration of the fluid in my right arm, guided by a second CT scan. The purpose of aspiration was to culture the fluid and to send it to a lab to determine organism/bacteria type.  The results of the culture would not be known until Thursday, 10/24/2013. In the interim, I was admitted as a patient on Tuesday night (10/22/2013) at approximately 9:00 PM and began a regimen of Azactam, an antibiotic, intravenously at the rate of 1 gram every 8 hours through Thursday, 10/24/2013, by the infectious disease doctor on call at the hospital. On Thursday morning, 10/24/2013, the results of the culture mentioned above were received by the hospital and the diagnosis was cellulitis. I was discharged by the infectious disease doctor on Thursday, 10/24/13 at 1:00 PM and was prescribed an oral antibiotic (Avelox  400 mg) by him to be taken at the rate of one tablet per day for 5 days. The discharge orders indicated that I was to follow-up with my primary physician, within one week of Thursday, 10/24/13.
Age: 83.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Cellulitis, Computerised tomogram abnormal, Culture positive, Incisional drainage, Local swelling
Clinical narrative: By 9:00 AM the day after the vaccine was administered (Friday, 10/18/2013) by my primary care physician, my right arm began to be swell and was painful.  By Tuesday, 10/22/2013, the swelling and pain became very severe.  I called my physician to advise him of these adverse events and he instructed me to immediately go to the ER room of my local hospital.  The ER doctors took my vital signs, performed a CT scan of my right arm, and then performed an aspiration of the fluid in my right arm, guided by a second CT scan. The purpose of aspiration was to culture the fluid and to send it to a lab to determine organism/bacteria type.  The results of the culture would not be known until Thursday, 10/24/2013. In the interim, I was admitted as a patient on Tuesday night (10/22/2013) at approximately 9:00 PM and began a regimen of Azactam, an antibiotic, intravenously at the rate of 1 gram every 8 hours through Thursday, 10/24/2013, by the infectious disease doctor on call at the hospital. On Thursday morning, 10/24/2013, the results of the culture mentioned above were received by the hospital and the diagnosis was cellulitis. I was discharged by the infectious disease doctor on Thursday, 10/24/13 at 1:00 PM and was prescribed an oral antibiotic (Avelox  400 mg) by him to be taken at the rate of one tablet per day for 5 days. The discharge orders indicated that I was to follow-up with my primary physician, within one week of Thursday, 10/24/13.
Age: 1.15
Sex: M
Vaccine: FLU4, HEPA, MMRV
Symptoms: Injection site erythema, Injection site rash
Clinical narrative: Red raised rash at site of Proquad (MMR-VZV) vaccine.
Age: 58.0
Sex: F
Vaccine: FLU3, TDAP
Symptoms: Back pain, Hypoaesthesia, Injected limb mobility decreased, Injection site pain, Insomnia
Clinical narrative: (R) delt 24 hour later pain at site of injection. Pt reports decreased ROM with pain radiating to back of shoulder pain, tingling, numbness in (R) 2nd and 3rd fingers unable to sleep x 2wks. Dull pain all the time.
Age: 58.0
Sex: F
Vaccine: FLU3, TDAP
Symptoms: Musculoskeletal pain, Pain, Paraesthesia
Clinical narrative: (R) delt 24 hour later pain at site of injection. Pt reports decreased ROM with pain radiating to back of shoulder pain, tingling, numbness in (R) 2nd and 3rd fingers unable to sleep x 2wks. Dull pain all the time.
Sex: U
Vaccine: MNQ
Symptoms: Product reconstitution issue
Clinical narrative: Event Desc: It was noted that four patients only received the liquid vial of the MENVEO vaccine. The vaccine has a powder vial and a liquid vial and the two are to reconstituted prior to administration. Manufacturer response for MENVEO vaccination, (brand not provided) (per site reporter). Letter received.
Age: 66.0
Sex: M
Vaccine: FLU3
Symptoms: Asthenia, Chills, Decreased appetite, Insomnia, Malaise
Clinical narrative: Flu shot October 4th. Product of Sanofi Pasteur lot UT4721AA expiration 04/08/14. Onset 10/8 of mild malaise; shaking rigors 8/10 with severe myalgia and weakness (so severe I thought it was the beginning of polymyalgia rheumatica); October 11th very sensitive unable to sleep more than 1 hour having to adjust position due to sensitivity of muscles (pain) and nausea and anorexia still without fever but episodes of shaking chills (can't get warm) and full rigors. October 14th no endurance and decreasing malaise and aches.
Age: 66.0
Sex: M
Vaccine: FLU3
Symptoms: Myalgia, Nausea, Pain, Tremor
Clinical narrative: Flu shot October 4th. Product of Sanofi Pasteur lot UT4721AA expiration 04/08/14. Onset 10/8 of mild malaise; shaking rigors 8/10 with severe myalgia and weakness (so severe I thought it was the beginning of polymyalgia rheumatica); October 11th very sensitive unable to sleep more than 1 hour having to adjust position due to sensitivity of muscles (pain) and nausea and anorexia still without fever but episodes of shaking chills (can't get warm) and full rigors. October 14th no endurance and decreasing malaise and aches.
Age: 66.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Asthenia, Chest discomfort, Chills, Dyspnoea, Malaise
Clinical narrative: Approximately 2 hours after patient received the vaccine, she developed difficulty breathing, chest tightness, weakness could barely move, chills and a fever of 100. She used a "rescue inhaler" she had on hand and took 2 BENADRYL. She still did not feel well the next day.
Age: 66.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Mobility decreased, Pyrexia
Clinical narrative: Approximately 2 hours after patient received the vaccine, she developed difficulty breathing, chest tightness, weakness could barely move, chills and a fever of 100. She used a "rescue inhaler" she had on hand and took 2 BENADRYL. She still did not feel well the next day.
Age: 66.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Chest discomfort, Dyspnoea, Laboratory test, Mobility decreased
Clinical narrative: Approximately 2 hours after patient received the vaccine, she developed difficulty breathing, chest tightness, weakness could barely move, chills and a fever of 100. She used a "rescue inhaler" she had on hand and took 2 BENADRYL. She still did not feel well the next day.
Sex: M
Vaccine: FLU3, PPV
Symptoms: Vaccination complication
Clinical narrative: Information has been received from a third party claims administrator on behalf of a pharmacy, concerning a male customer (age not reported) who on an unspecified date was vaccinated with the flu vaccine (manufacturer unspecified) and PNEUMOVAX23 and had an adverse reaction. The "date of loss" was reported as 03OCT2013. The Lot # reported for PNEUMOVAX23 was J004747. The expiration date reported as "2/14". (The expiration date in MARRS auto filled as 20JULY2014 based on the lot #). It was reported that it was unclear which vaccine he had the reaction to. Treatment and outcome of the adverse experience was unknown. Additional information has been requested.
Age: 44.0
Sex: F
Vaccine: HEP
Symptoms: Hepatitis B antibody negative
Clinical narrative: This spontaneous report as received from a pharmacist concerning a 44  year old female patient with reflux and arthritis. The pharmacist reported that a patient received an unspecified hepatitis B vaccine "about two years ago" (approximately in October 2011) and a titer was drawn on 19-AUG-2013 which resulted negative. Concomitant therapies included hydrochlorothiazide (manufacturer unknown). On an unspecified date, the patient sought unspecified medical attention. Since the hepatitis B vaccine as unknown to the pharmacist, his was reported as RECOMBIVAX. Additional information has been requested.
Age: 11.0
Sex: F
Vaccine: FLUN4
Symptoms: Dizziness, Headache
Clinical narrative: Student c/o headache and dizziness. Vital signs all stable, no temperature. No trmt. student.
Age: 70.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Blood pressure decreased, Chills, Feeling abnormal, Flushing, Pyrexia
Clinical narrative: Received influenza vaccine and PNEUMOVAX at primary care physician office 10/23/13 about 1400. Started feeling poorly about 4 hours later. Fever, chills, shaking. Reported to Emergency Room. B/P 159/72. Overtime BP dropped to 81/53. Also noted to have wheezing, flushing, generalized hives. Temperature 103.6.
Age: 70.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Tremor, Urticaria, Wheezing
Clinical narrative: Received influenza vaccine and PNEUMOVAX at primary care physician office 10/23/13 about 1400. Started feeling poorly about 4 hours later. Fever, chills, shaking. Reported to Emergency Room. B/P 159/72. Overtime BP dropped to 81/53. Also noted to have wheezing, flushing, generalized hives. Temperature 103.6.
Age: 72.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: Patient said arm was sore with redness extending from 1" below injection site toward hand. Resolved by itself within a few days.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site urticaria
Clinical narrative: This spontaneous report as received from a pharmacist refers to a 67 year old female patient with allergy. On 16-OCT-2013 the patient was vaccinated with ZOSTAVAX (lot# J003483, exp 29-JUN-2014, 0.65 ml, once, subcutaneous in the left deltoid area). On 17-OCT-2013, patient began to develop a reddened welt at her injection site. The patient reported that, though the pain and swelling seem to be subsiding, the area of redness was "radiating in a wider area" and the area is beginning to itch. The pharmacist had not observed the patient's injection site, so he did not know if she was developing a rash. The patient sought medical attention and no treatment was given. The outcome of the adverse events was reported as not recovered. Additional information has been requested.
Sex: U
Vaccine: MMR
Symptoms: Expired drug administered, No adverse event
Clinical narrative: This spontaneous report as received from a healthcare worker/medical assistant refers to a patient of unknown age. On 09-OCT-2013 the patient was vaccinated with 0.5 ml once of M-M-R II (lot # was reported as 137AA, exp August 2013) subcutaneously. The expiration date of M-M-R II was August 2013. No adverse effects reported. Healthcare  worker/medical assistant stated patient had received at an unspecified time in the past "2 M-M-R II doses and requested another dose" and additionally stated "we have an immune titer for her."Additional information has been requested.
Sex: F
Vaccine: HEP
Symptoms: Incomplete course of vaccination, No adverse event, Product quality issue
Clinical narrative: This spontaneous report was received from a physician refers to a female patient of unknown age. On an unknown date when the physician was ready to withdraw a dose of RECOMBIVAX HB (lot # 0908AA, expiration date 05-APR-2014, route not reported) to inject third dose for an adult patient, she found that vial was totally empty and physician did not have an extra vial and patient missed her third dose. No adverse effects reported. Product Quality Complaint (PQC) reported. Additional information has been requested.
Age: 77.0
Sex: F
Vaccine: FLU3
Symptoms: VIIth nerve paralysis
Clinical narrative: Received flu vaccine 10/7/13. Bell's palsy (L) side of face started 10/9/13. Examined at oral surgeon on 10/14/13 and primary MD on 10/15/13.
Age: 26.0
Sex: M
Vaccine: FLU3
Symptoms: Syncope
Clinical narrative: Pt fainted 10 mins after vaccine. Recovered and felt better. Did not go w/ ambulance to hospital. Vitals stable.
Age: 47.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Mobility decreased, Nodule, Rash, Skin warm
Clinical narrative: PNEUMOVAX left arm. 1 hour later had knot in arm, later in evening redness started, couldn't straighten arm, "red band", rash on skin wrapping around to the inside from the front, hot to touch, next day knot still there, pt has not taken anything PO or topical for pn. PCP contacted recommended to go to ER.