Age: 0.33
Sex: M
Vaccine: DTAP, HBHEPB, PNC, RV5
Symptoms: Oxygen saturation decreased, Pain, Pallor, Respiratory syncytial virus infection, Rhinorrhoea
Clinical narrative: The evening of the same day patient got his 4 month vaccinations he started to not feel well. He was in serious pain and didn't want to be left alone at all, if he fell asleep he would immediately wake up screaming if set down. Patient seemed to be in a lot of pain at least the first week and some of the second. Most days he had a lack of appetite and when he did eat he would throw up most of it. He is breastfed and for about 2 weeks prior to his shots he had been having rice cereal with a little fruit mixed in once a day. From 1/21 until 2/9 he stopped eating cereal and fruit because he was just too sick to eat. Now he is back to eating cereal with fruit and his appetite is definitely back to 'normal'. From 1/22 until 2/10 patient rarely had bowel movements and the ones he had were very small and watery, except for one BM on the 24th that had a pudding like consistency.  From 1/22 through current he has been extremely gassy which is unusual for him. From 1/22 to about 2/9 he was moody and crabby, before this patient was an extremely happy baby.  From 1/22 through current he is very clingy and does not want to sleep alone anymore, both being unusual for him. Also, he had been sleeping about 5 hours straight at night, from 1/21 to 2/9 he was waking up about every 2 hours. Patient had learned to roll from front to back about 3 weeks before his shots but absolutely refused to do 'tummy time' (he would scream when put on his stomach) from 1/22 until 2/3 and now he has forgotten how to roll. He seemed overly tired from 1/21 to 2/6. There were many days when patient would be really pale but his cheeks would be flushed. Starting about 1/28 he often had glassy, droopy eyes (usually one eye more droopy than the other but it would alternate) and he tended to 'zone out' on things (stare off into space) for long periods of time. On 1/28 to 1/29 he wasn't urinating very much. At one point he went for at least 5 hours without urinating.  Then the morning of the 29th around 10:30 he let loose and pretty much filled his diaper with urine. For patient's digestive problems we took him to the doctor once, on 1/25, and were told "he probably has a stomach bug." (We also brought up his digestive issues when we took him in for the RSV on 1/30 and 2/4 but the doctor wasn't concerned enough to investigate.)  RSV: Starting about the 23rd patient seemed a little phlegmy but it wasn't noticeable most of the time until the evening of the 29th.  He woke up on the 30th with a horrible cough that sounded like a seal barking. We took patient to the doctor on the 30th and were told that he had bronchiolitis, most likely had RSV. Mostly his only RSV symptom up until 2/3 was his cough but then on 2/3 he started wheezing a lot and his cough started to sound like a person with asthma. We took patient back to the doctor on 2/4 and were told that he definitely had RSV (without any tests done) and would probably start to get better soon.  His blood/oxygen levels were at 89 so we were told to watch him carefully to make sure he was getting enough oxygen. Sometime around 2/5 he started sneezing a lot and developed a lot of phlegm in his nostrils. His nose wasn't runny but every now and then a whole bunch of snot would come out all at once. Patient stopped talking from 1/29 until 2/9, it was very scary because he is a talkative child. I believe that it hurt him to talk so he decided not to. At this point he is still sneezy and snotty but his cough is much better (although definitely not gone yet).