Sex: F
Vaccine: UNK, PPV, PPV
Symptoms: Headache, Imaging procedure, Immunoglobulin therapy, Injection site bruising, Injection site pain
Clinical narrative: swelling, bruising and pain at the injection site; swelling, bruising and pain at the injection site; swelling, bruising and pain at the injection site; headaches; low platelet count of 1; severe anemia; severe intravitreal right sub hyaloid hemorrhage; severe intravitreal right sub hyaloid hemorrhage; required imaging and evaluation to rule out compartment syndrome; mild fasciitis; Indication: Stage 3 Chronic Kidney Disease; This spontaneous report has been received from a physician referring to a female child of unknown age. The patent had stage 3 chronic kidney disease, latex allergy, and nut allergy. The patient's concomitant medications included atropine eye drops and prednisolone acetate (PRED FORTE) eye drops. Information about historical condition was unknown.  On 07-MAR-2024, the patient was vaccinated with dose of pneumococcal 23v polysaccharide vaccine (PNEUMOVAX23) (lot#: 22827 is not valid for pneumococcal 23v polysaccharide vaccine (PNEUMOVAX23), and didn't match any company product; dose number, strength and expiration date were unknown) intramuscularly for stage 3 chronic kidney disease (product use in unapproved indication).     On 07-MAR-2024, within 2 hours after receiving the vaccine, the patient developed swelling, bruising and pain at the injection site. Her symptoms worsened over the next 3 days. On and unknown date in March 2024, she developed mild fasciitis, required imaging and evaluation to rule out compartment syndrome and she also developed low platelet count of 1 (unit not provided). She suffered complications with severe intravitreal right sub hyaloid hemorrhage. She developed severe anemia requiring a blood transfusion, intravenous immunogloblin (IVIG) and steroids. The patient developed headaches requiring a magnetic resonance imaging (MRI). From 10-MAR-2024 to 14-MAR-2024, the patient was admitted to the hospital (it was unknown if the above events occurred before or after the admission). On 11-MAR-2024, she did have an ophthalmology consult for blurry vision and required several topicals medications. The patient underwent computerized tomography (CT), MRI, X-ray and ultrasounds, and the results were not provided. The patient received topical steroids, blood transfusion and IVIG as treatments. Her platelet counts did return to normal. However, the mother recently reported to the physician that ophthalmology exams indicated she had recovered only 30% of the vision in her right eye. The outcome of the events swelling, bruising and pain at the injection site, mild fasciitis, compartment syndrome, severe anemia and headache was reported as not recovered. The outcome of low platelet count was recovered in 2024. The outcome of severe intravitreal right sub hyaloid hemorrhage was recovering.   The causality between the events of swelling, bruising and pain at the injection site, mild fasciitis, compartment syndrome, severe anemia, headache, low platelet count, and severe intravitreal right sub hyaloid hemorrhage and pneumococcal 23v polysaccharide vaccine (PNEUMOVAX23) was unknown.  The events headache, swelling, bruising and pain at the injection site, fasciitis and compartment syndrome were considered as resulting in hospitalization. The events of severe intravitreal right sub hyaloid hemorrhage were considered as resulting in hospitalization and disability. the events of severe anemia and low platelet count were considered as resulting in hospitalization and life-threatening.  Upon internal review, the events low platelet count, severe anemia, severe intravitreal right sub hyaloid hemorrhage and compartment syndrome were considered as medically significant.