Age: 64.0
Sex: M
Vaccine: PPV
Symptoms: Headache, Laboratory test abnormal, Pneumonia, Pyrexia
Clinical narrative: Information has been received from a male consumer who on 9/27/01 was vaccinated with pneumococcal vaccine 23 polyvalent (reported as 'ML 54440, Pasteur Merieux"). On 10/4/01, the pt experienced a severe headache followed by fever attacks reaching a temperature of 40.6C. The pt was seen by his family doctor who found "nothing since there were no obvious indications on the lung". The pt had no cold or any other influenza type symptoms. On 10/10/01, the pt was admitted to the local hospital where a chest x-ray revealed a "severe attack of pneumonia on the left part of the lung". There were no additional symptoms other than the high fever. The pt was treated with "a daily injection of liquid antibiotics" for a total of 10 days. He was hospitalized for a total of 5 days. The pt felt that the "sickness was introduced in (his) body from the injection of Pneumovax 23 on 9/27/01". Additional information has been requested. Follow up information from a physician indicated that the patient recovered on 10/15/01. Additionally, the physician considered a causal relationship with the vaccine as unlikely. Additional information from a physician's record noted that the patient was admitted to the hospital on 10/10/01 with one week old febrile infection, temperatures of up to 39 degrees C and headaches. On admisstion to the hospital, the patient was noted to be in good general condition and good nutritional state, conscious, awake and oriented in time and place, with no dyspnea, cyanosis, anemia, edema or jaundice. Skin and mucous membranes showed no signs of irritation. Lymph nodes were not palpably enlarged, pupils were of equal size. Heart and lung findings were unremarkable. Peripheral pulses were normal. Abdomen was soft, no defense or resistance and no tenderness. Peristalic sounds were present, liver and spleen not palpably enlarged, renal bed not painful to percussion. Rectal examination showed: rectal ampulla filled with soft brown feces, no resistance palpable. Gross examination of the skeletal and nervous systems were unremarkable. On admission, the patient had a temperature of 39.6C. X-rays showed extensive left-side infiltration, confirmed only by slightly increased inflammatory chemistry lab levels of CRP 8mg/dl. The patinet was placed on antibiotic therapy with ceftriaxone sodium and promptly became afebrile. On follow up the infiltrate was found to have receded. With prior insulin therapy, the patient's daily blood sugar profiles after defervescence were within the normal range. Laboratory results included: ESR 37/67 mm acc. to W; Leukocyte count 6100/mcL; erythrcyte count 4.06 mill/mcL; hemoglobin 12.2 g/dl; hematocrit 35.6%; MCV 88 mcm^3; platelets 259,000 mcL; differential leukocyte count (lymphocytes 6%, neutrophils 81%, basophils 1%, eosinophils 0%, monocytes 11%), CRP 8.7%; albumin 49.1%; alpha-globulins 6.7%; alpha2-globulins 14.7%; beta-globulins 9.6%l gamma-globulins 19.9%; glucose 216 mg/dl; GGT 50 U/L; alkaline phosphatase 181 U/L; cholinesterase 2215 U/L. The following values wre found to be within normal limits: total protein; bilirubin; uric acid; urea; creatinine; GOT; GPT; LDM; CK; CK-MB; cholinesterase; lipase; amylase; potassium; calcium; coagulation; TSH; Basal level; HbA1C 5.8%; urinary status. Aerobic and anaerobic blood cultures were negative. ECG showed sinus rhythm normal, normal heart position, heart rate 80/min and elevated wave in leads V2-V6. The chest x-ray showed extensive infiltrate in left lingula pulmonis area and a follow up chest x-ray showed regressive infiltrate. An abdominal ultrasound showed unremarkable findings. On 10/15/01, the patient terminated his stay in the hospital on his own responsibility against medical advise, afebrile and asymptomatic. Medication on discharge included ceftriaxone sodium, insulin, axubrochin, and protaphan. The patient's diet included 12 bread exchange units. No further information is available.