Age: 32.0
Sex: M
Vaccine: ANTH, FLU3, HEPA, SMALL, TYP, ANTH, FLU3, HEPA, SMALL, TYP
Symptoms: Injection site discharge, Injection site erythema, Injection site scab, Rash erythematous, Rash generalised
Clinical narrative: This case was received on 11 May 2012 via a third party query tool search on the VAERS database, under reference number 449084. A 32-year-old male patient received the following vaccinations on 31 October 2011: ACAM2000 (SP Biologics Co. lot number VV04-003-A), TYPHIM VI (Sanofi Pasteur SA lot number E05491), FLUZONE SV (Sanofi Pasteur Inc. lot number U1454912), anthrax (EMERGENT, lot number FAV281) and VAQTA (Merck lot number AHAVB459CB). The patient received the smallpox vaccine (SPV) in his left upper arm. He reported received two previous SPV during childhood and taking precautions to prevent autoinoculation and contact transmission. The patient had been changing the SPV site dressing after showering and reports normal site progression. The patient denied any fever, chills, myalgias, arthralgias or headaches during the first week post-vaccination. Also, denied any flushing, dyspnea, wheezing, facial swelling, itching or swelling of tongue, mouth or throat, or GI-related symptoms following vaccine receipt. The patient first noted the itchy rash on his neck 2 days ago (7 days post-vaccination, 07 November 2011) which spread to his chest and then "all over". The patient denied any lesions in his mouth or on his palms or soles. The rash was described as red bumps, no drainage from lesions, no scaling or peeling. Denied history of any similar rashes in the past. Denied any chronic skin conditions such as eczema, psoriasis, acne, etc. Denied allergies to medications, foods, latex or stings/bites. Only complaint today was itching. No chest pain, shortness of breath or palpitations. Results of the patient's exam included: alert, in no acute distress, not ill-appearing, oral cavity had no lesions seen in mouth, lungs clear to auscultation (CTA), no adventitious sounds were present, heart rate and rhythm were normal, heart sounds were normal, no murmurs were heard, more than 15 skin lesions primarily maculopapular lesions on the face, neck, trunk, chest, arms, thighs (reported, not examined), very few lesions below knees with no lesions on hands or feet. The exam was normal except as noted. The assessment of the injection site showed no abnormalities, the smallpox vaccination site on the left upper arm was examined and had scabbing with minimal drainage, minimal erythema surrounding area, no satellite lesions and no edema. At the follow-up visit on 14 November 2011, the rash on the face and neck markedly improved and new lesions on lower extremities (some appearing ecchymotic). No systemic symptoms. Photos and clinical notes from 09 November 2011 and 14 November 2011 will be sent with VAERS report. The patient's immune complex studies were pending. The patient had no current illnesses, a history of no known drug allergies (NKDA) and a tooth extraction on day of vaccine receipt and was started on penicillin (PCN), ibuprofen, TYLENOL #3 which the patient took for three days. The patient's outcome was not recovered. Documents held by sender: None.