Age: 17.0
Sex: M
Vaccine: HEPA, IPV, TYP
Symptoms: Musculoskeletal stiffness, Road traffic accident, Stomach discomfort, Vision blurred
Clinical narrative: Information has been received from a health care professional concerning a 17 year old male who on 12/12/00 was vaccinated IM with one dose of Hepatitis A virus vaccine inactivated. Concomitant therapy on  12/12/00 included a first dose IM of Typhoid VI polysaccharide vaccine (Typhim VI) and a sixth dose of poliovirus vaccine (IPOL). On 01/04/01, the patient was vaccinated IM with a 2nd dose of Typhoid VI polysaccharide vaccine (Typhim VI) (lot #R0384). It was reported that a few days before 01/19/01, the patient had complained to his mom about spasms in his right hand. On 01/19/01, after going to a high school play, the patient was driving home and had such a severe spasm in his right hand and arm that he was unable to drive or steer the car and went off the road into a ditch. The patient sustained no injuries from the accident. ON 03/05/01, the patient started taking malaria pills. Then on 03/12/01, he took two pills while in another country. While there, the patient continued to have spasms on the right side of his body, on of which was so severe, he fell to the ground with his eyes rolled back, but was able to hear those around him and could respond verbally but was unable to move. When the spasm was over he could move again. The patient  was taken to his primary care physician when he returned. At that time he was taken off his malaria medication. The patient continues to have increasing dizziness, which is sometimes accompanied with headaches and neck stiffness. The patient describes the dizziness as feeling like he is walking during an earthquake. The patient has been to a chiropractor more than once after 01/19/01. He has also experienced high blood pressure, which fluctuates between high and normal. Besides the dizziness, he complained of blurred vision. The patient has an appointment with an eye specialist on 05/02/01. He has not had any cold, sinus infection, fever, nausea, or vomiting. It was reported that he has had a "nervous stomach" and has bouts of diarrhea frequently. He has been checked for bowel problems with no specific bacteria or viral infections found. He was given "Meclovir" to treat the dizziness and possible middle ear infection. It was noted that the patient has had no spasms since returning from the other country. Additionally, it was noted that the patient has had an appointment regarding his blurred vision. There was no MRI or neuro testing done for the dizziness and spasms. The patient's experiences were determined to be Other Medical Events. No further info is available. Follow-up info from a health professional reported that the pt had an eye examination which was normal. He was seen by a neurologist who said the dizziness would disappear. As of 10/01/2001 the dizziness occurred once a month. It was noted thatt he pt had a second dose of hep A virus vaccine inactivated on 04/19/2001 with no problems. Additiomally, it was indicated that the nurse gave the second dose too early so the pt received a third dose on 10/01/2001 without any problems. The pt recovered in March 2001.