Age: 70.0
Sex: F
Vaccine: FLU3, PPV, FLU3, PPV
Symptoms: Viral infection, Vomiting
Clinical narrative: Diagnosis: Pericardial Viral Syndrome. Manifestation In: Large pericardial effusion. Bilateral partially loculated pleural effusions. Basilar atelectasis/consolidation, right greater than the left. Observed: Elevated liver enzymes. Atrial fibrillation for 3 hrs on Oct 211. Swollen ankles. Background: Oct 6 - Th Received annual flu shot (FLULAVAL) and a pneumonia shot. Oct 8 - Sat When lay down to sleep, seized by sudden pain across chest and neck followed by chills with low grade fever, which lasted most of the night. Developed body ache, intensified by preexisting fibromyalgia. Treated with aspirin for fever and arnica gel for body pains. Oct 9 - Sun Fever and chills subsided. Decided to continued with planned trip, as had already paid for a condo for a week. Continued to treat chest and neck pain and all other body aches with aspirin, arnica gel, salonpas, plus massaging by partner and gentle stretching. Oct 10 - Mon Rested, read, did emails, jaccusi. Continued treating with aspirin, arnica gel salonpas, massaging, gentle stretching. Oct 11 - Tu As above, plus professional deep tissue massage. Oct 12 - We Aches in lower body gone, but increased pain across upper left quadrant of back. Decided to try to a short (3hr round-trip) hike with elevation of 1500 feet from 6000 ft. Shortness of breath and increasing pain across left back and down left arm. Decided to cut short the vaccination and return in order to see a doctor. Oct 12 - Th Saw Dr. in the office of my primary care physician, who was not available. By then, the upper left quadrant of back seemed hard as a rock and the pain "unbearable." Dr. diagnosed acute muscle spasm and prescribed 600 mg Ibuprofen 3X per day and FLEXERIL 2X per day. This I did for six days, with only modest improvement in back pain. Mild chest and throat pain was continuing. During this time, did not drive and kept activities at a low level. Stopped medications on Oct 18, as beginning to feel slightly nauseated and didn't like the somewhat spaced out feeling from the FLEXERIL. Oct 18 - Tu Visited acupuncturist, driven there by my partner. Got About 50 percent reduction in back pain. Oct 20 - Th Visited acupuncturist again, driven by my partner. Received some additional lessening of back pain and pain down left arm gone. Partner also drove me to an appointment with Dr., my cardiologist to adjust my high blood pressure medication. I told him about the acute pain and muscle spasm in the upper left quadrant of my back and the relief I received from the acupuncturist. He said he got a lot of back muscle spasms, too, and used a device called a Back Buddy for relief and Thai massage. That night, I vomited up my dinner and had some fluid diarrhea during the night. Oct 21 - Fri Partner left early morning on previous scheduled visit to her father in a nursing home I vomited up my breakfast and was unable to keep any food down all day, even sips of clear beverage. Fluid diarrhea continued during morning, then stopped. Breathing was shallow and could not speak normally due to feeling of constriction in chest and throat. Bloating of abdomen, both stomach and intestine. Oct 22 - Sat In morning, friend drove me to walk-in urgent care clinic provided. Dr. found fluid around lungs in chest x-ray and elevated liver enzymes. He arranged for me to be admitted to Hospital. At Hospital, admitted by a doctor, whom I never met. Attending physician was on the third floor cardiac section, who came to visit every day. She ordered tests and heart monitor. ATRIAL FRIBILLATION 7:30-10:30 PM. Heart brought back to normal rhythm by IV administration of Amiodarone. Partner cut short father visit, flew back, arriving about midnight. On 23 - Sun Shortness of breath and chest pain if tired to breathe deeply. Body pain across entire upper back, especially left side, so could only sleep lying on right side. Some relief from arnica gel in the day and salonpas at night, which I brought with me. Was offered TYLENOL, but refused, since it never helped with my fibromyalgia pain. Less upper body pain, if sat up in chair during the day. Dr., cardiologist, stopped by to say he felt the atrial fibrillation was related to there being extra fluid around heart and not of permanent concern at present. The heart monitor recorded no more episodes during my hospital stay. Presumably, once the excess fluid is removed from my body, my heart will be fine, as there were no other serious findings. Right thoracentesis performed that day, yielding 850 mL of fluid. Also, got LASIX thru IV. Oct 24 - Mon Dr. visited my room to say I needed to stay for at least 24 hours under observation, as sometimes a lung could collapse after thoracentesis. Also, would need an x-ray to see how much fluid remained on the left side around my heart and left lung. If less than 300 mL would probably no extract, but let nature deal with it over time. Got LASIX thru IV to help the process. Oct 25 - Tu After x-ray, was told I could be discharged. Dr gave my final diagnosis as Pericardial Viral Syndrome. When I asked to speak to Dr., his explanation was that I had had an adverse reaction to the flu shot and had gotten the equivalent of a touch of flu. He said I should be happy not to have gotten the flu itself, which would have kept me in hospital longer. He said as badly as I felt, all vaccine have the probability that a few will have acute reactions, but they are still worth getting. I was discharged from the hospital around 4:30 PM.