Age: 23.0
Sex: M
Vaccine: ANTH, HEP
Symptoms: Headache, Hyperhidrosis, Hypertension, Influenza like illness, Joint range of motion decreased
Clinical narrative: Reports flu like symptoms following each anthrax vaccine - diarrhea, nausea and vomiting, generalized body aches, fever, and chills ; also experienced sinus congestion, post-nasal discharge, and sore throat. He usually woke up with above symptoms the morning following receipt of the anthrax vaccines ; the symptoms seem to peak around day 3 or 4, and resolved by day 6-7. Reports diarrhea the whole time he was in Iraq until present. In 10/04, experiencing changes in his visual perception. Describes these episodes "like eyes going back and forth" but if he were to look in mirror, his eyes would not be moving. The visual changes are worse with head movements and usually only last seconds. In 10/04, began experiencing polyarthralgias. He describes the sensation as aching, like with the flu or "like a toothache". All joints are affected and usually ache all at the same time. The joints that ache the most are his elbows, knees, and hands. He has had 2 episodes of his right elbow becoming edematous, erythematous, and warm; his movement was limited due to pain. Experienced joint pain and swelling of his fingers, but no redness or warmth of affected joints; this continues to occur 1-2 times per week; he says his hands turn white during these episodes and he experiences associated joint stiffness. Rheumatology evaluation was negative for inflammatory joint disease. Around 10/04, began experiencing chronic headaches. Headache pain is located at base of neck and described as sharp, throbbing pain. Typically awakens with pain and headaches usually last about 3 hours. Rates level of pain intensity as a level 7. Headaches occur almost every morning. OTC medications like Aleve provide relief. While deployed in 03/05, experienced sensation of dizziness. Besides the feeling of dizziness, he feels unsteady, like he is ready to fall over. He describes this sensation as imbalance or feeling like he is going to faint. The sensation usually comes on gradually and lasts 1-2 days. Episodes occur about every 3 weeks. Movement and position changes seem to precipitate and aggravate senstion. He says when he turns his head and looks in one direction, his body sways that way. When dizzy, he also notes the onset of altered sensation/paresthesias affecting his teeth, tongue and digits. He also describes the sensation of feeling like water is dripping down the side of my face. Has noted feeling cold, but experiencing sweats during episodes of dizziness. Denies black outs or fainting. Denies rapid respirations or hyperventilation prior to onset of intermittent, bilateral tinnitus over the last year, usually lasting a few seconds. Tinnitus does not interfere with activities of daily living, but is sometimes distracting and makes concentration difficult. During his deployment, began experiencing intermittent, brief episodes of palpitations with sensation of heart beating out of my chest. Counted his pulse during a few episodes and his pulse was over 100 (tachycardia). When he was able to seek medical attention, elevated blood pressure measurements were noted. Some of episodes were associated with dizziness. No previous history of blood pressure elevation prior to deployment.