chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Ear pain, Encephalitis, Flank pain, Headache, Hypokinesia
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Infection, Lethargy, Multi-organ failure, Otitis media, Pyrexia
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Viral infection, Vomiting
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Abdomen scan normal, Abdominal pain, Acute haemorrhagic leukoencephalitis, Antinuclear antibody positive, Bacterial culture negative
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Blood test normal, Brain oedema, Computerised tomogram abnormal, Culture negative, Death
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Dizziness, Dysuria, Extubation, Eye movement disorder, Gastroenteritis viral
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Gaze palsy, Gram stain negative, Headache, Intensive care, Intubation
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Leukoencephalomyelitis, Lumbar puncture abnormal, Otitis media, Prothrombin time prolonged, Pupils unequal
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Pyrexia, Renal failure, Urine analysis normal, Vomiting
Clinical narrative: First visit PCP office 8/9/06 vomiting, headache and stomach x 1 day. Diagnosis viral syndrome, headache, abdominal pain, medications: none. Seen at medical center ER 8/10/06 earache started on 8/10/06 am. Diagnosis Otitis media. Treatment Auralgan and Zithromax. Seen at medical center ER 8/14/06 abdominal and flank pain, painful urination and vomiting. Morphine given in ER. Seen at medical center ER 8/15/06 lethargic, weak, low grade fever, and unable to get out of bed and walk. Developed these symptoms on 8/15/06. Diagnosis encephalitis. He was transferred to another Hospital. Patient died on 8/21/06. Autopsy revealed acute hemorrhagic leukoencephalitis (Hurst disease), a rare, fulminant form of acute disseminated encephalomyelitis. The cause of death was likely acute disseminated encephalomyelitis secondary to prominent cytokine release prompted from a prior infection, which ultimately let to development of early DIC and multi organ system failure. 01/16/07-records received and reviewed from Med Ctr.  ER visits 8/14/06 and 8/16/06.  DX on 8/16/06- meningoencephalitis, cerebral edema. 02/09/07-records received and reviewed from another Hospital for DOS 8/15-8/21/06 DC DX: Cerebral edema basal ganglia edema with right sided thalamic edema in a vascular distribution antiphospholipid antibody positive Presented to ER with persistent vomiting times 10 days leading to ataxia and altered mental status. On transfer to another Hospital he was intubated for a Glasgow Coma Score of 8 Hospital course included antimicrobial therapy and steroids.  Developed hydrocephalus and an EVD was placed and subsequently lost all cranial nerve function and was noted on hospital day 6 to be breathing only slightly on the ventilator, also had renal insufficiency of unknown etiology with a rising creatinine. Hypertensive episode with bradycardia and expired.  Neuro exam: pupils 2mm and nonreactive to light on left side and 3-2mm and nonreactive to light on right side. Doll eye sign negative. No response to deep pain stimulation. Deep tendon reflexes 0-1 plus. Babinski sign negative. Clonus negative. Gag reflex negative. Funduscopic exam shows obvious papillary edema on right side, left eye was unable to be examined due to small size. Intermittent spontaneous movement of right arm. no movement of left arm.
Age: 0.18
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV, PNC
Symptoms: Crying, Social avoidant behaviour
Clinical narrative: Patient did nothing but cry and sleep for 2 weeks after receiving initial (2 month old) vaccines - DTaP, HepB, Hib, IPV, Prevnar. He did not want to be touched or moved. He has since received DT seperately without incident.
Age: 19.0
Sex: F
Vaccine: HPV4, MNQ, HPV4, MNQ
Symptoms: Paraesthesia
Clinical narrative: Reporter states 19 year old female received Menactra on 12/28/06. On Jan. 7, 2007, patient reported tingling sensation from feet to thighs. Returned to school. Will be seen by physician.
Age: 19.0
Sex: F
Vaccine: HPV4, MNQ, HPV4, MNQ
Symptoms: Full blood count normal, Guillain-Barre syndrome, Hyporeflexia, Lumbar puncture, Pain
Clinical narrative: Reporter states 19 year old female received Menactra on 12/28/06. On Jan. 7, 2007, patient reported tingling sensation from feet to thighs. Returned to school. Will be seen by physician.
Age: 0.6
Sex: F
Vaccine: HIBV
Symptoms: Increased appetite, Irritability, Lymphadenopathy, Pallor, Pyrexia
Clinical narrative: Slight fever, fussy, appetite change, sleep pattern change, paleness, activity change, 01/04/07 infant tylenol at night. Hoarseness, rash on ears, 01/07/07. Rash on face and chest, enlarged lymph nodes on base of skull, 01/08/07. Checked by doctor on 01/08/07 no treatment needed.
Age: 0.6
Sex: F
Vaccine: HIBV
Symptoms: Rash, Sleep disorder
Clinical narrative: Slight fever, fussy, appetite change, sleep pattern change, paleness, activity change, 01/04/07 infant tylenol at night. Hoarseness, rash on ears, 01/07/07. Rash on face and chest, enlarged lymph nodes on base of skull, 01/08/07. Checked by doctor on 01/08/07 no treatment needed.
Age: 1.31
Sex: F
Vaccine: DTAP, HIBV, IPV, MMR
Symptoms: Rash erythematous, Urticaria
Clinical narrative: She received the MMR vacination on December 12, 2006 and on December 20, 2006 in the p.m. she started breaking out in these small red, slightly raised, red bumps. They were about as big as a pencil eraser head.  I did not think too much about it she had a few on her stomach and a couple on her leg.  I noticed these when I was putting her down for the night on the 20th.  She had been playing with the Christmas tree branches and I thought these were marks from the branches.  She is fair skinned and marks easily.  The next morning when I changed her diaper, she was covered in hives.  The places that were just small red bumps the night before were now these large red welts.  I called Dr's office and they got me right in that morning.  He diagnosed them as hives and said more than likely they were a reaction to the MMR shot.  He recommended Benadryl 1/4 teaspoon.  These were completely gone by 12/26/2006.
Age: 58.0
Sex: F
Vaccine: FLU3
Symptoms: Hypoaesthesia, Paraesthesia
Clinical narrative: Patient states of right arm tingling and numbness at times ever since receiving influenza vaccine.
Age: 15.0
Sex: F
Vaccine: HEPA, TDAP
Symptoms: Blood pressure decreased, Dizziness, Hypoxia, Pallor
Clinical narrative: Patient became light-headed after receiving Hep A and Tdap 25 minutes prior. Patient had not eaten anything on this day, and had just completed 6 minutes of exercise just before receiving vaccines. She was quite anxious about receiving vaccines. She was light-headed and pale.BP 83/38 HR 63 RR 16. Oxygen administered, and patient was transported to the hospital ED via ambulance.
Age: 73.0
Sex: F
Vaccine: DTAP, PPV
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pruritus
Clinical narrative: 10-12cm x 20cm sharply-demarcated area of erythema at injection site on left upper arm. Patient reports warmth, swelling and redness immediately after injection. She reported it one week later because it getting bigger and continues to itch.
Age: 1.5
Sex: M
Vaccine: DTAP, FLU3, HEPA, VARCEL
Symptoms: Irritability, Tremor, Vomiting
Clinical narrative: Mom states child was shaking and wobbly for about 5 minutes no LOC, vomited once afterwards, cranky, whiny today, otherwise tolerating oral fluids well.
Age: 0.17
Sex: M
Vaccine: DTAPHEPBIP, HBHEPB, PNC, RV5
Symptoms: Irritability, Pain
Clinical narrative: There was no adverse event related to receiving the combination of the following vaccines: Pediarix, Prevnar as usual but, was given Comvax instead of HIB and therefore received an adult dose of Hepatitis B verses a Pediatric dose.  Provider did contact a Pediatric Collegue for guidance in responding to the situation.  Dr. contacted the patient's mother and spoke to her in regards to the situation in receiving the additional Hepatitis B vaccination and reassured the mother that this should not result in any harm to the patient and recommended to the mother to administer Tylenol to lessen the post vaccine pain and irritability.  It may benefit to administer the appropriate dosage of Tylenol every 4 hours for the next 24 hours and to contact her if she had any concerns.  No further concerns have been noted since 12/27/06.
Age: 19.0
Sex: F
Vaccine: HPV4
Symptoms: Injection site erythema, Pruritus, Urticaria
Clinical narrative: Information has been received from a nurse practitioner concerning a 19 year old female who on 15 Dec 2006 was vaccainted with her first dose of HPV Vaccine. Subsequently the patient experienced welts on her legs, itching and redness of her injection site arm. The patient was treated with BENADRYL, and she recovered. The patient sought unspecified medical attention. The reporter considered the patient's welts on her legs, itching and redness of her injection site arm to be other important medical events. Additional information has been requested.
Age: 24.0
Sex: F
Vaccine: HPV4
Symptoms: Abortion, Unintended pregnancy
Clinical narrative: Initial and follow up information has been received from a licensed practical nurse through the manufacturer pregnancy registry concerning a 24 year old female with a history of two miscarriages in the past and not planning on being pregnant, a spontaneous abortion (March 2006) and no known allergies reported. On 20 Nov 2006, the patient was vaccinated intramuscularly in the left deltoid with the first 0.5ml dose of HPV vaccine (lot #653978/0955F). On 20 Nov 2006, the patient had a pelvic ultrasound performed due to pelvic pain. The pelvic ultrasound revealed fluid in pelvis and no intrauterine pregnancy was seen (previously reported as was negative for pregnancy). On an unspecified date, post vaccination, the patient presented to the office stating that she took a urine home pregnancy test and it was positive. On 04 Dec 2006, the patient had blood work drawn which revealed positive for pregnancy. The patient was approximately 6 weeks gestation with last menstrual period noted as approximately 21 Oct 2006. The patient was scheduled for a follow up blood test on 07 Dec 2006 and an ultrasound and blood lab was scheduled on 11 Dec 2006. On 17 Dec 2006 the patient experienced spontaneous abortion. The patient sought unspecified medical attention. At the time of this report, the outcome of the event was unknown. Upon internal review, the spontaneous abortion was considered to be an other important medical event (OMIC).
Age: 14.0
Sex: F
Vaccine: TDAP
Symptoms: Dyskinesia, Loss of consciousness, Pain, Tremor
Clinical narrative: Received Boostrix in the left deltoid 530 pm on 12/27/06, other twenty minutes later she started shaking. She was unconscious for a couple of minutes while jerking. Immediately prior to this she noticed pain in her right arm.
Age: 5.0
Sex: M
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site swelling, Pharyngolaryngeal pain, Pyrexia, Rash scarlatiniform
Clinical narrative: Patient in with sore throat, fever, and scarlet rash. SA positive diagnosed with Strep pharynigitis with scarlitone form rash. Mom asked me to look at injection site where he received his Influenza vaccine 3 days prior. The injection site was swollen and erythematous and somewhat tender. Treated with Keflex 250 mg/5 ml 1 1/2 tsp TID for 6 days.
Age: 5.0
Sex: M
Vaccine: FLU3
Symptoms: Tenderness
Clinical narrative: Patient in with sore throat, fever, and scarlet rash. SA positive diagnosed with Strep pharynigitis with scarlitone form rash. Mom asked me to look at injection site where he received his Influenza vaccine 3 days prior. The injection site was swollen and erythematous and somewhat tender. Treated with Keflex 250 mg/5 ml 1 1/2 tsp TID for 6 days.
Age: 16.0
Sex: M
Vaccine: FLU3
Symptoms: Medication error
Clinical narrative: Administered Fluarix to 16 1/2 year old patient vaccine is for 18 years and older.
Sex: F
Vaccine: FLU3, HEPA, HIBV, MMRV
Symptoms: Rash macular
Clinical narrative: 2 weeks after receiving vaccines presented to office with diffuse macular rash on face, scalp, chest and back. No other symptoms.
Age: 2.0
Sex: F
Vaccine: DT, HIBV
Symptoms: Decreased appetite, Rash
Clinical narrative: Developed appetite few days after HIB (Pedvax), five rash 2-3 days after decrease appetite.
Age: 34.0
Sex: F
Vaccine: PPV
Symptoms: Pain
Clinical narrative: Received pneumo vaccine from medical clinic, lot 0885 F, Exp 11/18/08 called office with complain of left deltoid pain. Seen in office.
Age: 32.0
Sex: F
Vaccine: MMR
Symptoms: Pruritus, Swelling face
Clinical narrative: Swollen lips, itching arms and neck, OTC Benadryl by patient. Kenalog 40 mg on 1/9/07.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Dermatitis bullous, Pruritus, Rash papular
Clinical narrative: After over a month post vaccine developed small papular rashes, varicella-like rashes over ears, chest, back, trunk with some pruritus.
Age: 0.34
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC, RV5
Symptoms: Swelling, Urticaria
Clinical narrative: 24 hours after vaccination patient developed urticarical rash trunk, cheeks, arms, legs, white lip and swelling. Getting better.
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Rash maculo-papular, Skin ulcer, Urticaria
Clinical narrative: Patient received Zostavax vaccination 12/15/06. Seen in office 12/18/06 - redness to site/ upper arm. Seen 12/27/06 - urticaria, slightly raised, maculo-papular lesions over torso, extremities and head. Zyrtec, Benadryl as needed.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Bronchiolitis, Dyspnoea, Wheezing
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Apnoea, Bacteria urine, Bacteria urine identified, Blood calcium normal, Blood chloride normal
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Blood creatinine normal, Blood culture, Blood glucose increased, Blood glucose normal, Blood potassium normal
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Blood sodium normal, Blood urea normal, Bronchial obstruction, Bronchiolitis, Chest X-ray abnormal
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Cough, Culture urine, Dyspnoea, Full blood count, Haematocrit normal
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Haemoglobin normal, Hypotonia, Lumbar puncture, Lung hyperinflation, Metabolic function test
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Nasal congestion, Oxygen saturation decreased, Pallor, Platelet count normal, Protein urine present
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Pyrexia, Red blood cells urine positive, Respiratory arrest, Specific gravity urine increased, Unresponsive to stimuli
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Upper respiratory tract infection, Urine analysis, Urine output decreased, Vomiting, White blood cell count normal
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: X-ray
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Apnoea, Blood bicarbonate, Blood calcium normal, Blood chloride normal, Blood creatinine
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Blood glucose increased, Blood potassium normal, Blood sodium normal, Blood urea normal, Bronchial obstruction
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Bronchiolitis, Chest X-ray, Cough, Culture urine, Dyspnoea
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Full blood count, Haematocrit decreased, Haemoglobin decreased, Hypotonia, Increased upper airway secretion
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Listless, Metabolic function test, Nasal congestion, Pallor, Platelet count
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Platelet count normal, Pyrexia, Respiratory arrest, Unresponsive to stimuli, Upper respiratory tract infection
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 0.18
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5, DTAP, HBHEPB, IPV, PNC, RV5
Symptoms: Urine analysis, Urine output decreased, Vomiting, White blood cell count, White blood cell count normal
Clinical narrative: Wheezing, resp difficulty approx 12 hours after vaccine, called EMS admit to hospital x 2 day DX with bronchiolitis.  1/23/07 Received medical records from hospital which reveal patient admitted 12/28-12/30/06 for 3 day hx of cough & congestion who became limp & had oral cyanosis.  Temp 101.2 in ER & admitted for r/o sepsis. Had mod amount of resp secretions which required frequent suctioning & bulb suctioning upon d/c to home. No antibiotics given but required IV rehydration. FINAL DX: acute life threatening event; bronchiolitis; & fever.
Age: 58.0
Sex: M
Vaccine: FLU3
Symptoms: Guillain-Barre syndrome
Clinical narrative: Unclear relation- no prodromal viral illness- had Flu shot now with Guillian Barre Syndrome. (OMIC).  1/22/07 Received medical records from hospital which reveal patient admitted 12/12-12/25/06 for weakness of his legs.  Exam revealed areflexia of the LEs.  Neuro consult & EMG done & dx w/GBS. No LP done with this admission.  Treated w/IVIG x 5 days w/considerable improvement.  D/C to home w/home health for PT & tapering prednisone for prurtis to IVIG. Patient was readmitted to hospital on 12/17-12/22/06 with recurrence of GBS.  S/S of weakness of LEs esp below the knee with dull aching.  Exam revealed areflexia below the knees.  LP done in ER.  Received additional IVIG over 5 days. FINAL DX: Guillain Barre Syndrome.
Age: 63.0
Sex: F
Vaccine: PPV, PPV
Symptoms: Cellulitis, Contusion, Injection site erythema, Injection site induration, Injection site pain
Clinical narrative: Patient was ordered Pneumovax per physician orders. Patient was given injection on 12/9/06 in the left arm at 1213. On 12/11/06 the patient complained to nursing of a throbbing pain at the injection site. Area appeared to be bruised and firm to the touch. Over the next few days the patient continued to complain of pain at the injection site and was given pain medications per orders. On 12/18/06 the area was red with a 1.5cm yellow slough and a white center. The wound care nurse described this as a bulla with atropical center and erythematic peri wound 3cm across. Patient also later received antibiotics for possible cellulitis. Symptoms eventually began to resolve.
Age: 63.0
Sex: F
Vaccine: PPV, PPV
Symptoms: Injection site vesicles, Skin discolouration
Clinical narrative: Patient was ordered Pneumovax per physician orders. Patient was given injection on 12/9/06 in the left arm at 1213. On 12/11/06 the patient complained to nursing of a throbbing pain at the injection site. Area appeared to be bruised and firm to the touch. Over the next few days the patient continued to complain of pain at the injection site and was given pain medications per orders. On 12/18/06 the area was red with a 1.5cm yellow slough and a white center. The wound care nurse described this as a bulla with atropical center and erythematic peri wound 3cm across. Patient also later received antibiotics for possible cellulitis. Symptoms eventually began to resolve.
Age: 63.0
Sex: F
Vaccine: PPV, PPV
Symptoms: Injection site bruising, Injection site erythema, Injection site induration, Injection site pain, Injection site vesicles
Clinical narrative: Patient was ordered Pneumovax per physician orders. Patient was given injection on 12/9/06 in the left arm at 1213. On 12/11/06 the patient complained to nursing of a throbbing pain at the injection site. Area appeared to be bruised and firm to the touch. Over the next few days the patient continued to complain of pain at the injection site and was given pain medications per orders. On 12/18/06 the area was red with a 1.5cm yellow slough and a white center. The wound care nurse described this as a bulla with atropical center and erythematic peri wound 3cm across. Patient also later received antibiotics for possible cellulitis. Symptoms eventually began to resolve.