chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 93.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram head, Condition aggravated, Dementia, Fall, Feeding disorder
Clinical narrative: Patient slept after going home and got progressively worse and was admitted to hospital then was discharged to hospice.  Per Daughter.   Was reported to Moderna and CDC
Age: 93.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Unresponsive to stimuli
Clinical narrative: Patient slept after going home and got progressively worse and was admitted to hospital then was discharged to hospice.  Per Daughter.   Was reported to Moderna and CDC
Age: 93.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: Patient slept after going home and got progressively worse and was admitted to hospital then was discharged to hospice.  Per Daughter.   Was reported to Moderna and CDC
Age: 15.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Headache, Malaise, Pyrexia
Clinical narrative: low grade fever; headache; fatigue; malaise; This is a spontaneous report from a contactable consumer or other non hcp.  A 15-years-old female patient received first dose of bnt162b2 (BNT162B2, Solution for injection, Batch/lot number and expiry date: not reported) via an unspecified route of administration on 13May2021 (at the age of 15-years-old) as SINGLE DOSE for covid-19 immunisation.  Patient medical history and concomitant medication were not reported. Mother stated that the side effects started the next day on 14May2021. She was experiencing low grade fever, headache, fatigue, and malaise (on 14May2021). The had talked to her Doctor and they did not seem to know much since the vaccine was so new for this age group. There were adults in their house hold who had gotten the vaccine and had not has side effects like this. It been Friday, Saturday, Sunday, Monday, and now Tuesday.  It was enquired about how long were these side effects going to last. The outcome of the events was unknown  E-transmitting for possible duplicate information. 15 year old female consumer.  No follow up attempts possible. Information on lot/batch number cannot be obtained
Age: 15.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Body temperature, Chest pain, Fatigue, Headache, Malaise
Clinical narrative: low grade fever; headache; fatigue; malaise; This is a spontaneous report from a contactable consumer or other non hcp.  A 15-years-old female patient received first dose of bnt162b2 (BNT162B2, Solution for injection, Batch/lot number and expiry date: not reported) via an unspecified route of administration on 13May2021 (at the age of 15-years-old) as SINGLE DOSE for covid-19 immunisation.  Patient medical history and concomitant medication were not reported. Mother stated that the side effects started the next day on 14May2021. She was experiencing low grade fever, headache, fatigue, and malaise (on 14May2021). The had talked to her Doctor and they did not seem to know much since the vaccine was so new for this age group. There were adults in their house hold who had gotten the vaccine and had not has side effects like this. It been Friday, Saturday, Sunday, Monday, and now Tuesday.  It was enquired about how long were these side effects going to last. The outcome of the events was unknown  E-transmitting for possible duplicate information. 15 year old female consumer.  No follow up attempts possible. Information on lot/batch number cannot be obtained
Age: 15.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, SARS-CoV-2 test, Tachycardia
Clinical narrative: low grade fever; headache; fatigue; malaise; This is a spontaneous report from a contactable consumer or other non hcp.  A 15-years-old female patient received first dose of bnt162b2 (BNT162B2, Solution for injection, Batch/lot number and expiry date: not reported) via an unspecified route of administration on 13May2021 (at the age of 15-years-old) as SINGLE DOSE for covid-19 immunisation.  Patient medical history and concomitant medication were not reported. Mother stated that the side effects started the next day on 14May2021. She was experiencing low grade fever, headache, fatigue, and malaise (on 14May2021). The had talked to her Doctor and they did not seem to know much since the vaccine was so new for this age group. There were adults in their house hold who had gotten the vaccine and had not has side effects like this. It been Friday, Saturday, Sunday, Monday, and now Tuesday.  It was enquired about how long were these side effects going to last. The outcome of the events was unknown  E-transmitting for possible duplicate information. 15 year old female consumer.  No follow up attempts possible. Information on lot/batch number cannot be obtained
Age: 15.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Fatigue, Headache, Malaise, Pyrexia
Clinical narrative: low grade fever; headache; fatigue; malaise; This is a spontaneous report from a contactable consumer or other non hcp.  A 15-years-old female patient received first dose of bnt162b2 (BNT162B2, Solution for injection, Batch/lot number and expiry date: not reported) via an unspecified route of administration on 13May2021 (at the age of 15-years-old) as SINGLE DOSE for covid-19 immunisation.  Patient medical history and concomitant medication were not reported. Mother stated that the side effects started the next day on 14May2021. She was experiencing low grade fever, headache, fatigue, and malaise (on 14May2021). The had talked to her Doctor and they did not seem to know much since the vaccine was so new for this age group. There were adults in their house hold who had gotten the vaccine and had not has side effects like this. It been Friday, Saturday, Sunday, Monday, and now Tuesday.  It was enquired about how long were these side effects going to last. The outcome of the events was unknown  E-transmitting for possible duplicate information. 15 year old female consumer.  No follow up attempts possible. Information on lot/batch number cannot be obtained
Age: 25.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoaesthesia, Injection site pain
Clinical narrative: my left leg and left arm went numb; This is a spontaneous report from a contactable consumer (patient). A 25-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EW 0179), via an unspecified route, administered in left arm on 01May2021 at 06:00 (at the age of 25-year-old), as first dose, single for covid-19 immunization at Workplace clinic. The patient's medical history was not reported. Concomitant medication included medroxyprogesterone acetate (DEPO-PROVERA). The patient previously took diphenhydramine hydrochloride (BENADRYL) and Amoxicillin and experienced allergies with both the drugs. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was never tested for COVID-19. The patient was not pregnant and did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient reported that about an hour after the vaccination, her left leg and left arm went numb on 01May2021 at 07:00, and it stayed numb for at least an hour before she fell asleep. No treatment was administered for the event. The outcome was reported as recovered on 01May2021 at 08:00.
Age: 25.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoaesthesia
Clinical narrative: my left leg and left arm went numb; This is a spontaneous report from a contactable consumer (patient). A 25-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EW 0179), via an unspecified route, administered in left arm on 01May2021 at 06:00 (at the age of 25-year-old), as first dose, single for covid-19 immunization at Workplace clinic. The patient's medical history was not reported. Concomitant medication included medroxyprogesterone acetate (DEPO-PROVERA). The patient previously took diphenhydramine hydrochloride (BENADRYL) and Amoxicillin and experienced allergies with both the drugs. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was never tested for COVID-19. The patient was not pregnant and did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient reported that about an hour after the vaccination, her left leg and left arm went numb on 01May2021 at 07:00, and it stayed numb for at least an hour before she fell asleep. No treatment was administered for the event. The outcome was reported as recovered on 01May2021 at 08:00.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cardiogenic shock, Multiple organ dysfunction syndrome, Myocarditis
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acidosis, Antinuclear antibody, Aspiration, Blood lactate dehydrogenase increased, Blood pH decreased
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Body temperature increased, C-reactive protein increased, Cardiac failure congestive, Cardiogenic shock, Catheterisation cardiac normal
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray abnormal, Diarrhoea, Dyspnoea, Echocardiogram, Ejection fraction decreased
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Endotracheal intubation, HIV test, Intensive care, Laboratory test abnormal, Lung infiltration
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Malaise, Mechanical ventilation, Mitral valve incompetence, Myalgia, Oropharyngeal pain
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pericardial effusion, Polyuria, Pregnancy test negative, Pulmonary oedema, Renal replacement therapy
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Respiratory viral panel, Rheumatoid factor, SARS-CoV-2 test negative, Sinus congestion, Transaminases increased
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Troponin, Viral myocarditis
Clinical narrative: From Infectious Disease provider consult note on 5/14/2021: On 5/9, she developed sore throat, sinus congestion, mild diarrhea, myalgia, and malaise.  Over the next few days, developed increasing SOB and progressive orthopnea.  On 5/13, she came to ED where she had temp of 101.9 and bilateral infiltrates on chest xray.  Was given antibiotics and 1L of fluid and promptly developed apparent congestive heart failure.  Cardiology consulted and TTE (5/13) showed severe global dysfunction w/ EF of 30%, moderate MR, and small pericardial effusion w/ no evidence of tamponade. Labs unremarkable except CRP 4.9, COVID neg (5/13 and 5/14), HIV, ANA, rheum factor, pregnancy neg.  Diuresed w/ Lasix, but 12 hours into admission (on 5/13/21), worsened w/ temp 102.2 and increased pulm edema on CXR.  Labs on 5/14/21 showed pH 7.06 due to acute AG acidosis, AKI 1.6, mild transaminitis, trop 4600, LDH<2250.  Had cardiac cath on 5/13 that was normal. Patient was intubated, aspirated, and re-intubated.  Transferred to Medical Center on 5/14/2021 for further advanced cardiac care. At that time, had severe cardiogenic shock and suspected viral illness resulting in viral myocarditis.   From CSICU progress note 5/23/2021: Placed on ECMO on May 14th and decannulated on May 21st. Remains in ICU for ongoing balloon pump, ventilator, and CRRT requirement. Repeat TTE planned for 5/24/21. Continuing to wean toward extubation.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Abdominal pain, Adverse drug reaction, Blood pressure increased, Blood test, Computerised tomogram abdomen abnormal
Clinical narrative: presents  5/8/2021 with red/bloody lesions inside bilateral cheeks, lower lips for the past 5 days or so. Patient denies any new medications.  Patient denies any pain in her body, she noted increased bruising (right hand), and small dots on her skin appear everywhere. She has never had low platelets before. She denies taking any new supplements. She only takes levothyroxine and no other medications at home. She denies taking Aspirin and denies .  admit to inpatient Med Surg, patient with most likely ITP with wet purpura, diffuse petechiae and with platelet of 12K. Patient is currently not actively having any without GI bleed or profuse bleeding. HGB   12.0         Patient  received IV IG infusions on 5/11 and 5/12, as well as continued steroids, and received platelets transfusions ,  Platelets improved to > 50 K by 5/12/2021 , and felt well and ready to go home . On 5/25/21 patient readmitted due to worsening thrombocytopenia during outpatient follow-up.  At last admission, patient had thrombocytopenia with minor oral bleeding and petechial rash, and was sent home on steroid taper. Patient reports tapering down on prednisone as directed, but she began to note increased bruising all over her body, most prominently on her arms. Notes her gums began to ooze again a couple days ago. No hematuria, no melena or dark tarry stools.   will treat with IVIG 1g/kg and rituximab.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Contusion, Dyspnoea, Gingival bleeding, Hypoaesthesia, Immune thrombocytopenia
Clinical narrative: presents  5/8/2021 with red/bloody lesions inside bilateral cheeks, lower lips for the past 5 days or so. Patient denies any new medications.  Patient denies any pain in her body, she noted increased bruising (right hand), and small dots on her skin appear everywhere. She has never had low platelets before. She denies taking any new supplements. She only takes levothyroxine and no other medications at home. She denies taking Aspirin and denies .  admit to inpatient Med Surg, patient with most likely ITP with wet purpura, diffuse petechiae and with platelet of 12K. Patient is currently not actively having any without GI bleed or profuse bleeding. HGB   12.0         Patient  received IV IG infusions on 5/11 and 5/12, as well as continued steroids, and received platelets transfusions ,  Platelets improved to > 50 K by 5/12/2021 , and felt well and ready to go home . On 5/25/21 patient readmitted due to worsening thrombocytopenia during outpatient follow-up.  At last admission, patient had thrombocytopenia with minor oral bleeding and petechial rash, and was sent home on steroid taper. Patient reports tapering down on prednisone as directed, but she began to note increased bruising all over her body, most prominently on her arms. Notes her gums began to ooze again a couple days ago. No hematuria, no melena or dark tarry stools.   will treat with IVIG 1g/kg and rituximab.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Immunoglobulin therapy, Mouth haemorrhage, Nephrolithiasis, Platelet count decreased, Sedative therapy
Clinical narrative: presents  5/8/2021 with red/bloody lesions inside bilateral cheeks, lower lips for the past 5 days or so. Patient denies any new medications.  Patient denies any pain in her body, she noted increased bruising (right hand), and small dots on her skin appear everywhere. She has never had low platelets before. She denies taking any new supplements. She only takes levothyroxine and no other medications at home. She denies taking Aspirin and denies .  admit to inpatient Med Surg, patient with most likely ITP with wet purpura, diffuse petechiae and with platelet of 12K. Patient is currently not actively having any without GI bleed or profuse bleeding. HGB   12.0         Patient  received IV IG infusions on 5/11 and 5/12, as well as continued steroids, and received platelets transfusions ,  Platelets improved to > 50 K by 5/12/2021 , and felt well and ready to go home . On 5/25/21 patient readmitted due to worsening thrombocytopenia during outpatient follow-up.  At last admission, patient had thrombocytopenia with minor oral bleeding and petechial rash, and was sent home on steroid taper. Patient reports tapering down on prednisone as directed, but she began to note increased bruising all over her body, most prominently on her arms. Notes her gums began to ooze again a couple days ago. No hematuria, no melena or dark tarry stools.   will treat with IVIG 1g/kg and rituximab.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cheilitis, Contusion, Gingival disorder, Haematocrit decreased, Haemoglobin decreased
Clinical narrative: presents  5/8/2021 with red/bloody lesions inside bilateral cheeks, lower lips for the past 5 days or so. Patient denies any new medications.  Patient denies any pain in her body, she noted increased bruising (right hand), and small dots on her skin appear everywhere. She has never had low platelets before. She denies taking any new supplements. She only takes levothyroxine and no other medications at home. She denies taking Aspirin and denies .  admit to inpatient Med Surg, patient with most likely ITP with wet purpura, diffuse petechiae and with platelet of 12K. Patient is currently not actively having any without GI bleed or profuse bleeding. HGB   12.0         Patient  received IV IG infusions on 5/11 and 5/12, as well as continued steroids, and received platelets transfusions ,  Platelets improved to > 50 K by 5/12/2021 , and felt well and ready to go home . On 5/25/21 patient readmitted due to worsening thrombocytopenia during outpatient follow-up.  At last admission, patient had thrombocytopenia with minor oral bleeding and petechial rash, and was sent home on steroid taper. Patient reports tapering down on prednisone as directed, but she began to note increased bruising all over her body, most prominently on her arms. Notes her gums began to ooze again a couple days ago. No hematuria, no melena or dark tarry stools.   will treat with IVIG 1g/kg and rituximab.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Immune thrombocytopenia, Immunoglobulin therapy, Lip haemorrhage, Mouth haemorrhage, Oral disorder
Clinical narrative: presents  5/8/2021 with red/bloody lesions inside bilateral cheeks, lower lips for the past 5 days or so. Patient denies any new medications.  Patient denies any pain in her body, she noted increased bruising (right hand), and small dots on her skin appear everywhere. She has never had low platelets before. She denies taking any new supplements. She only takes levothyroxine and no other medications at home. She denies taking Aspirin and denies .  admit to inpatient Med Surg, patient with most likely ITP with wet purpura, diffuse petechiae and with platelet of 12K. Patient is currently not actively having any without GI bleed or profuse bleeding. HGB   12.0         Patient  received IV IG infusions on 5/11 and 5/12, as well as continued steroids, and received platelets transfusions ,  Platelets improved to > 50 K by 5/12/2021 , and felt well and ready to go home . On 5/25/21 patient readmitted due to worsening thrombocytopenia during outpatient follow-up.  At last admission, patient had thrombocytopenia with minor oral bleeding and petechial rash, and was sent home on steroid taper. Patient reports tapering down on prednisone as directed, but she began to note increased bruising all over her body, most prominently on her arms. Notes her gums began to ooze again a couple days ago. No hematuria, no melena or dark tarry stools.   will treat with IVIG 1g/kg and rituximab.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Petechiae, Platelet count decreased, Platelet transfusion, Purpura, Skin disorder
Clinical narrative: presents  5/8/2021 with red/bloody lesions inside bilateral cheeks, lower lips for the past 5 days or so. Patient denies any new medications.  Patient denies any pain in her body, she noted increased bruising (right hand), and small dots on her skin appear everywhere. She has never had low platelets before. She denies taking any new supplements. She only takes levothyroxine and no other medications at home. She denies taking Aspirin and denies .  admit to inpatient Med Surg, patient with most likely ITP with wet purpura, diffuse petechiae and with platelet of 12K. Patient is currently not actively having any without GI bleed or profuse bleeding. HGB   12.0         Patient  received IV IG infusions on 5/11 and 5/12, as well as continued steroids, and received platelets transfusions ,  Platelets improved to > 50 K by 5/12/2021 , and felt well and ready to go home . On 5/25/21 patient readmitted due to worsening thrombocytopenia during outpatient follow-up.  At last admission, patient had thrombocytopenia with minor oral bleeding and petechial rash, and was sent home on steroid taper. Patient reports tapering down on prednisone as directed, but she began to note increased bruising all over her body, most prominently on her arms. Notes her gums began to ooze again a couple days ago. No hematuria, no melena or dark tarry stools.   will treat with IVIG 1g/kg and rituximab.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Thrombocytopenia, White blood cell count normal
Clinical narrative: presents  5/8/2021 with red/bloody lesions inside bilateral cheeks, lower lips for the past 5 days or so. Patient denies any new medications.  Patient denies any pain in her body, she noted increased bruising (right hand), and small dots on her skin appear everywhere. She has never had low platelets before. She denies taking any new supplements. She only takes levothyroxine and no other medications at home. She denies taking Aspirin and denies .  admit to inpatient Med Surg, patient with most likely ITP with wet purpura, diffuse petechiae and with platelet of 12K. Patient is currently not actively having any without GI bleed or profuse bleeding. HGB   12.0         Patient  received IV IG infusions on 5/11 and 5/12, as well as continued steroids, and received platelets transfusions ,  Platelets improved to > 50 K by 5/12/2021 , and felt well and ready to go home . On 5/25/21 patient readmitted due to worsening thrombocytopenia during outpatient follow-up.  At last admission, patient had thrombocytopenia with minor oral bleeding and petechial rash, and was sent home on steroid taper. Patient reports tapering down on prednisone as directed, but she began to note increased bruising all over her body, most prominently on her arms. Notes her gums began to ooze again a couple days ago. No hematuria, no melena or dark tarry stools.   will treat with IVIG 1g/kg and rituximab.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Amnesia, Aphasia, Confusional state, Dialysis, Feeling hot
Clinical narrative: Patient manifested with flu-like symptoms (myalgias, fatigue, cough, abdominal discomfort, shortness of breath) with high-grade fevers (TMax 103F) approximately 4-6 hours following administration of 2nd Moderna vaccine on 5/4/2021 per patient's wife. The symptoms progressively worsened to the point that he presented to an outside hospital on 5/12/2021 at which time he was found to be tachycardic and febrile (T 103.1F). Labs at that time were notable for significant thrombocytopenia, elevated creatinine, elevated lactate, elevated procalcitonin. Chest imaging showed bilateral airspace disease. CT of the abdomen noted hepatosplenomegaly with no evidence of lymphadenopathy. Echocardiogram showed normal cardiac function. He was empirically started on broad-spectrum antibiotics. Labs on 5/13/2021 were notable for a markedly elevated ferritin level, fasting hypertriglyceridemia, elevated CRP, elevated transaminase levels, hyperbilirubinemia, markedly elevated CXCL-9 level, markedly elevated IL-18 level, normal natural killer cell function. Of note, while his blood and urine cultures were negative, he was found to have elevated EBV viral load on peripheral blood draw. He had a bone marrow biopsy which reportedly showed rare evidence of cells with what appeared to be erythrocytes within their cytoplasm, concerning for HLH.  Given strong clinical and serological suspicion for HLH, he was transferred to our hospital for a higher level of care. Upon transfer to our facility on 5/18/2021, his inflammatory markers were persistently elevated. He unfortunately developed worsened renal and respiratory failure, and required both hemodialysis and intubation respectively. He was continued on empiric broad-spectrum antibiotics, however we additionally initiated high-dose steroids as well as anakinra for treatment of HLH. Given EBV viremia, we also began rituximab therapy. He was successfully extubated, however as of 5/26/2021 remains dialysis-dependent with continued improvement in urinary output. His post-intubation course has been complicated by encephalopathy of unknown etiology. We have consulted infectious disease to proceed with a diagnostic lumbar puncture to ascertain potential CNS pathogens explaining the cause of his altered mental status. MRI of the brain showed no evidence of pathology. CNS involvement by HLH remains on our differential.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: General physical condition abnormal, Intensive care, Life support, Memory impairment, Multi-organ disorder
Clinical narrative: Patient manifested with flu-like symptoms (myalgias, fatigue, cough, abdominal discomfort, shortness of breath) with high-grade fevers (TMax 103F) approximately 4-6 hours following administration of 2nd Moderna vaccine on 5/4/2021 per patient's wife. The symptoms progressively worsened to the point that he presented to an outside hospital on 5/12/2021 at which time he was found to be tachycardic and febrile (T 103.1F). Labs at that time were notable for significant thrombocytopenia, elevated creatinine, elevated lactate, elevated procalcitonin. Chest imaging showed bilateral airspace disease. CT of the abdomen noted hepatosplenomegaly with no evidence of lymphadenopathy. Echocardiogram showed normal cardiac function. He was empirically started on broad-spectrum antibiotics. Labs on 5/13/2021 were notable for a markedly elevated ferritin level, fasting hypertriglyceridemia, elevated CRP, elevated transaminase levels, hyperbilirubinemia, markedly elevated CXCL-9 level, markedly elevated IL-18 level, normal natural killer cell function. Of note, while his blood and urine cultures were negative, he was found to have elevated EBV viral load on peripheral blood draw. He had a bone marrow biopsy which reportedly showed rare evidence of cells with what appeared to be erythrocytes within their cytoplasm, concerning for HLH.  Given strong clinical and serological suspicion for HLH, he was transferred to our hospital for a higher level of care. Upon transfer to our facility on 5/18/2021, his inflammatory markers were persistently elevated. He unfortunately developed worsened renal and respiratory failure, and required both hemodialysis and intubation respectively. He was continued on empiric broad-spectrum antibiotics, however we additionally initiated high-dose steroids as well as anakinra for treatment of HLH. Given EBV viremia, we also began rituximab therapy. He was successfully extubated, however as of 5/26/2021 remains dialysis-dependent with continued improvement in urinary output. His post-intubation course has been complicated by encephalopathy of unknown etiology. We have consulted infectious disease to proceed with a diagnostic lumbar puncture to ascertain potential CNS pathogens explaining the cause of his altered mental status. MRI of the brain showed no evidence of pathology. CNS involvement by HLH remains on our differential.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Ocular hyperaemia, Pyrexia, Tremor
Clinical narrative: Patient manifested with flu-like symptoms (myalgias, fatigue, cough, abdominal discomfort, shortness of breath) with high-grade fevers (TMax 103F) approximately 4-6 hours following administration of 2nd Moderna vaccine on 5/4/2021 per patient's wife. The symptoms progressively worsened to the point that he presented to an outside hospital on 5/12/2021 at which time he was found to be tachycardic and febrile (T 103.1F). Labs at that time were notable for significant thrombocytopenia, elevated creatinine, elevated lactate, elevated procalcitonin. Chest imaging showed bilateral airspace disease. CT of the abdomen noted hepatosplenomegaly with no evidence of lymphadenopathy. Echocardiogram showed normal cardiac function. He was empirically started on broad-spectrum antibiotics. Labs on 5/13/2021 were notable for a markedly elevated ferritin level, fasting hypertriglyceridemia, elevated CRP, elevated transaminase levels, hyperbilirubinemia, markedly elevated CXCL-9 level, markedly elevated IL-18 level, normal natural killer cell function. Of note, while his blood and urine cultures were negative, he was found to have elevated EBV viral load on peripheral blood draw. He had a bone marrow biopsy which reportedly showed rare evidence of cells with what appeared to be erythrocytes within their cytoplasm, concerning for HLH.  Given strong clinical and serological suspicion for HLH, he was transferred to our hospital for a higher level of care. Upon transfer to our facility on 5/18/2021, his inflammatory markers were persistently elevated. He unfortunately developed worsened renal and respiratory failure, and required both hemodialysis and intubation respectively. He was continued on empiric broad-spectrum antibiotics, however we additionally initiated high-dose steroids as well as anakinra for treatment of HLH. Given EBV viremia, we also began rituximab therapy. He was successfully extubated, however as of 5/26/2021 remains dialysis-dependent with continued improvement in urinary output. His post-intubation course has been complicated by encephalopathy of unknown etiology. We have consulted infectious disease to proceed with a diagnostic lumbar puncture to ascertain potential CNS pathogens explaining the cause of his altered mental status. MRI of the brain showed no evidence of pathology. CNS involvement by HLH remains on our differential.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal discomfort, Biopsy bone marrow abnormal, Blood creatinine increased, Blood culture negative, Blood lactic acid increased
Clinical narrative: Patient manifested with flu-like symptoms (myalgias, fatigue, cough, abdominal discomfort, shortness of breath) with high-grade fevers (TMax 103F) approximately 4-6 hours following administration of 2nd Moderna vaccine on 5/4/2021 per patient's wife. The symptoms progressively worsened to the point that he presented to an outside hospital on 5/12/2021 at which time he was found to be tachycardic and febrile (T 103.1F). Labs at that time were notable for significant thrombocytopenia, elevated creatinine, elevated lactate, elevated procalcitonin. Chest imaging showed bilateral airspace disease. CT of the abdomen noted hepatosplenomegaly with no evidence of lymphadenopathy. Echocardiogram showed normal cardiac function. He was empirically started on broad-spectrum antibiotics. Labs on 5/13/2021 were notable for a markedly elevated ferritin level, fasting hypertriglyceridemia, elevated CRP, elevated transaminase levels, hyperbilirubinemia, markedly elevated CXCL-9 level, markedly elevated IL-18 level, normal natural killer cell function. Of note, while his blood and urine cultures were negative, he was found to have elevated EBV viral load on peripheral blood draw. He had a bone marrow biopsy which reportedly showed rare evidence of cells with what appeared to be erythrocytes within their cytoplasm, concerning for HLH.  Given strong clinical and serological suspicion for HLH, he was transferred to our hospital for a higher level of care. Upon transfer to our facility on 5/18/2021, his inflammatory markers were persistently elevated. He unfortunately developed worsened renal and respiratory failure, and required both hemodialysis and intubation respectively. He was continued on empiric broad-spectrum antibiotics, however we additionally initiated high-dose steroids as well as anakinra for treatment of HLH. Given EBV viremia, we also began rituximab therapy. He was successfully extubated, however as of 5/26/2021 remains dialysis-dependent with continued improvement in urinary output. His post-intubation course has been complicated by encephalopathy of unknown etiology. We have consulted infectious disease to proceed with a diagnostic lumbar puncture to ascertain potential CNS pathogens explaining the cause of his altered mental status. MRI of the brain showed no evidence of pathology. CNS involvement by HLH remains on our differential.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood test abnormal, C-reactive protein increased, Chemokine increased, Chest X-ray abnormal, Computerised tomogram abdomen abnormal
Clinical narrative: Patient manifested with flu-like symptoms (myalgias, fatigue, cough, abdominal discomfort, shortness of breath) with high-grade fevers (TMax 103F) approximately 4-6 hours following administration of 2nd Moderna vaccine on 5/4/2021 per patient's wife. The symptoms progressively worsened to the point that he presented to an outside hospital on 5/12/2021 at which time he was found to be tachycardic and febrile (T 103.1F). Labs at that time were notable for significant thrombocytopenia, elevated creatinine, elevated lactate, elevated procalcitonin. Chest imaging showed bilateral airspace disease. CT of the abdomen noted hepatosplenomegaly with no evidence of lymphadenopathy. Echocardiogram showed normal cardiac function. He was empirically started on broad-spectrum antibiotics. Labs on 5/13/2021 were notable for a markedly elevated ferritin level, fasting hypertriglyceridemia, elevated CRP, elevated transaminase levels, hyperbilirubinemia, markedly elevated CXCL-9 level, markedly elevated IL-18 level, normal natural killer cell function. Of note, while his blood and urine cultures were negative, he was found to have elevated EBV viral load on peripheral blood draw. He had a bone marrow biopsy which reportedly showed rare evidence of cells with what appeared to be erythrocytes within their cytoplasm, concerning for HLH.  Given strong clinical and serological suspicion for HLH, he was transferred to our hospital for a higher level of care. Upon transfer to our facility on 5/18/2021, his inflammatory markers were persistently elevated. He unfortunately developed worsened renal and respiratory failure, and required both hemodialysis and intubation respectively. He was continued on empiric broad-spectrum antibiotics, however we additionally initiated high-dose steroids as well as anakinra for treatment of HLH. Given EBV viremia, we also began rituximab therapy. He was successfully extubated, however as of 5/26/2021 remains dialysis-dependent with continued improvement in urinary output. His post-intubation course has been complicated by encephalopathy of unknown etiology. We have consulted infectious disease to proceed with a diagnostic lumbar puncture to ascertain potential CNS pathogens explaining the cause of his altered mental status. MRI of the brain showed no evidence of pathology. CNS involvement by HLH remains on our differential.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cough, Culture urine negative, Device dependence, Dyspnoea, Echocardiogram normal
Clinical narrative: Patient manifested with flu-like symptoms (myalgias, fatigue, cough, abdominal discomfort, shortness of breath) with high-grade fevers (TMax 103F) approximately 4-6 hours following administration of 2nd Moderna vaccine on 5/4/2021 per patient's wife. The symptoms progressively worsened to the point that he presented to an outside hospital on 5/12/2021 at which time he was found to be tachycardic and febrile (T 103.1F). Labs at that time were notable for significant thrombocytopenia, elevated creatinine, elevated lactate, elevated procalcitonin. Chest imaging showed bilateral airspace disease. CT of the abdomen noted hepatosplenomegaly with no evidence of lymphadenopathy. Echocardiogram showed normal cardiac function. He was empirically started on broad-spectrum antibiotics. Labs on 5/13/2021 were notable for a markedly elevated ferritin level, fasting hypertriglyceridemia, elevated CRP, elevated transaminase levels, hyperbilirubinemia, markedly elevated CXCL-9 level, markedly elevated IL-18 level, normal natural killer cell function. Of note, while his blood and urine cultures were negative, he was found to have elevated EBV viral load on peripheral blood draw. He had a bone marrow biopsy which reportedly showed rare evidence of cells with what appeared to be erythrocytes within their cytoplasm, concerning for HLH.  Given strong clinical and serological suspicion for HLH, he was transferred to our hospital for a higher level of care. Upon transfer to our facility on 5/18/2021, his inflammatory markers were persistently elevated. He unfortunately developed worsened renal and respiratory failure, and required both hemodialysis and intubation respectively. He was continued on empiric broad-spectrum antibiotics, however we additionally initiated high-dose steroids as well as anakinra for treatment of HLH. Given EBV viremia, we also began rituximab therapy. He was successfully extubated, however as of 5/26/2021 remains dialysis-dependent with continued improvement in urinary output. His post-intubation course has been complicated by encephalopathy of unknown etiology. We have consulted infectious disease to proceed with a diagnostic lumbar puncture to ascertain potential CNS pathogens explaining the cause of his altered mental status. MRI of the brain showed no evidence of pathology. CNS involvement by HLH remains on our differential.