chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 69.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Arrhythmia, Blood pressure increased, Heart rate increased, Heart rate irregular, Hypertension
Clinical narrative: On 11/02/2006 I received a Flu shot and a Pneumonia shot. Flu symptoms of aches and listlessness lasted for over two months - Elevated Blood Pressure, pulse rate increase and irregular heart beat started immediatly after receiving the shots and lasted for over six months.  My doctor immediately prescribed blood pressure medication.  When the high blood pressure and arythmia persisted, I had a complete cardiac screening and blood workup.  The symtoms were declared "innocent." In the last six months my body has slowly come back to normal.  My pulse is regular, although still higher than previously.  My blood pressure is slightly lower than before, however, I am now on medication...Lisinopril and triamterene.
Age: 69.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Listless, Pain
Clinical narrative: On 11/02/2006 I received a Flu shot and a Pneumonia shot. Flu symptoms of aches and listlessness lasted for over two months - Elevated Blood Pressure, pulse rate increase and irregular heart beat started immediatly after receiving the shots and lasted for over six months.  My doctor immediately prescribed blood pressure medication.  When the high blood pressure and arythmia persisted, I had a complete cardiac screening and blood workup.  The symtoms were declared "innocent." In the last six months my body has slowly come back to normal.  My pulse is regular, although still higher than previously.  My blood pressure is slightly lower than before, however, I am now on medication...Lisinopril and triamterene.
Age: 78.0
Sex: M
Vaccine: VARZOS
Symptoms: Herpes zoster, Injection site rash
Clinical narrative: Pt developed shinges rash at site of vaccination,started the day of vaccination and got progressively worse over 12 days treated with Valtrex
Age: 4.0
Sex: M
Vaccine: FLUX
Symptoms: Cough, Crying, Headache, Pyrexia, Respiratory tract congestion
Clinical narrative: Flumist Saturday 11/03/2007 in am at School clinic by Health Department. Monday 11-05-07 104 degree fever, he was crying because of headaches, congestion, cough.  Better 11-09-07 (sister got headache and fever 102 degree, but better within 24 hours.)
Age: 73.0
Sex: M
Vaccine: FLU3
Symptoms: Guillain-Barre syndrome, Intensive care, Paraesthesia, Plasmapheresis
Clinical narrative: Patient admitted to the hospital with nonspecific paresthesia.  Patient immediately went to the ICU for observation due to questionable pulmonary status, but never required intubation; total ICU stay was 14 days.  Neurology was consulted and diagnosed the patient with Guillain-Barre syndrome.  He was treated with IVIG 36 gm daily for 5 days, with little improvement.  After completing the IVIG he received 5 days of plasmaphoresis.  Upon completion of the plasmaphoresis, he started to show improved strength and swallowing capabilities.  As patient improves it is anticipated that he will be transferred to a skilled nursing unit or inpatient rehab unit to complete his recovery.  11/19/2007 ER record received from 10/29/2007. Pt presented with abrupt onset of numbness of hands and feet, weakness, and feeling poorly. (+) walking difficulty.  PE (+) for ataxia, unsteady and broad-based gait. Loss of sense of touch both hands and leg.  Admitted  with assessment: Hypokalemia.  Weakness. Paresthesias. 11/26/2007 D/C summary recived for DOS 10/30-11/20/2007 with D/C DX:  Guillain-Barre syndrome.  Autonomic Instability.  Aspiration Pneumonia.  Dysphagia.  Peripheral Neuropathy.  Squamous cell carcinoma of the scalp. Neurology consult found no DTRs on PE.  Strength 3/5 and diminished sensation lower extremities.  Prelim DX was ascending sensory motor polyneuropathy, likely GBS.  Pt received IVIG and plasmapheresis with increase in strength noted.  Pt had an episode of aspiration which did not require intubation. Pt experienced orthostatic hypotension and worsening peripheral neuropathy (burning sensation in both legs) during hospital stay. D/C to SNF on 11/20/2007.   12/28/07 Additional records received. Pt re-admitted 11/20-29/2007 for Partial SBO and again 12/5-14/07 for inpatient rehab for mobility impairments.
Age: 0.5
Sex: F
Vaccine: DTAPHEPBIP, FLU3, HIBV
Symptoms: Erythema, Swelling
Clinical narrative: Pediarix and Flu vaccines were given subcutaneously in the patients right leg. Reddness and swelling occured no treatment neccessary
Age: 50.0
Sex: F
Vaccine: TDAP
Symptoms: Pain in extremity, Rash erythematous, Rash macular
Clinical narrative: Pain in the Left deltoid with irregular macular erythematous rash 20cm in length and variably 6.5 to 4 cm wide longitudinally up and down arm
Age: 6.0
Sex: U
Vaccine: HEPA
Symptoms: Erythema, Oedema peripheral, Vomiting
Clinical narrative: Client received 2nd Hep A immunization.  Arm swollen and red - started vomiting- cannot keep water down.  Has not had any reaction to any previous vaccinations.
Age: 1.25
Sex: M
Vaccine: DTAPHEPBIP, FLU3, HIBV, MMRV, PNC
Symptoms: Blister, Pyrexia
Clinical narrative: Fever of 104 on 11/15/2007, white blisters on tongue. Medicated with infant Tylenol drops without a decrease in temperature.  Medicated with Ibuprofen 1.8ML with fever reducing to 102 on day 2 of vaccinations.
Age: 12.0
Sex: F
Vaccine: FLU3, MNQ, TDAP
Symptoms: Injection site urticaria, Pruritus, Urticaria
Clinical narrative: Hives at site of injection, R arm, measuring 8-9 cm, also itchy hives on neck and chest
Age: 28.0
Sex: F
Vaccine: HEP
Symptoms: Diarrhoea, Headache, Nausea, Pain, Pyrexia
Clinical narrative: 11/14/2007 At approximately 6 pm.  2.5-3 hours after receiving the Hepatitis vaccine, the patient experienced onset of body aches, nausea, headache, diarrhea, fever.  Symptoms persisted  throughout the night with patient awakening every 2 hours due to symptoms.  11/15/07 @ 12:30 pm (21 hours after receiving the vaccine, the patient contacted RN to report the illness.  The patient was referred to a health care provider of her choice.  Per patient verbal report11/16/07:  Patient was seen in the afternoon of 11/15/07 by Dr.  No treatment administered. Advised illness probably adverse reaction  to vaccine.  11/16/07 11:00 am.: patient continuing to experience body aches and head aches, but symptoms less severe and "not as sick as yesterday".
Age: 59.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Injected limb mobility decreased, Joint range of motion decreased, Pain in extremity, Throat tightness
Clinical narrative: Received PPV23 and influenza vaccines in right arm 11/14/07 approx 11 a.m. at our Health Dept  influenza immunization clinic. Client stated that approx 3 p.m., arm pain began, self-described as "excruciating with loss of range of motion." Stated he took 800 mg ibuprofen approx 6:30 p.m. then Vicodin Plus at 10:30 p.m. Stated at 12:30 a.m. "throat felt like it was closing up, I was afraid for my life, I slept sitting up in chair so I could breathe." His spouse notified our flu clinic staff of client condition on 11/15, who advised ER or personal physician follow-up; client contacted his physician who advised trip to ER if breathing problem worsened; client stated arm had "pulsating pain" on 11/15. On 11/16 during follow-up phone call stated arm "still not fully mobile, can't lift it" completely. Stated no fever during episode. We advised further contact with his physician as necessary.
Age: 37.0
Sex: F
Vaccine: RUB
Symptoms: Arthralgia, Arthritis
Clinical narrative: Arthritic like pain in fingers for approximately 3 months after the vaccination.  Fingers ached especially at night.  Physician diagnosed arthritis.
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Craniotomy, Haemorrhagic arteriovenous malformation, Nuclear magnetic resonance imaging
Clinical narrative: Information has been received from a Registered Nurse concerning a 14 year old female patient who was vaccinated IM with a third dose of Gardasil. The nurse reported that 2 months after the vaccination patient was diagnosed with a bleeding arteriovenous malformation. It was reported that patient was hospitalized (date and duration not reported) and had a craniotomy. The patient had a magnetic resonance imaging (MRI) diagnostic test done but no result was available. No other information was available. The outcome was unknown. The reporter considered the event as disabling and life threatening. The reporter felt that patient having arteriovenous malformation was a serious other medical event because it required craniotomy. Additional information has been requested.
Age: 27.0
Sex: F
Vaccine: HPV4
Symptoms: Drug exposure during pregnancy, Ectopic pregnancy, Inappropriate schedule of drug administration, Surgery
Clinical narrative: Information has been received from a 27 year old female consumer with no pertinent medical history and no known allergies, who on 02-MAR-2007 was vaccinated with the first dose of Gardasil (lot # not provided). There was no concomitant medication. At some time in March 2007, she unknowingly became pregnant (date of LMP and estimated date of delivery not provided). On 07-MAY-2007, still unaware that she was pregnant, she was vaccinated with the second dose of Gardasil (lot # not provided). On 09-MAY-2007 she had surgery for an ectopic pregnancy, and was hospitalized for one day. Subsequently, the patient recovered from the events (duration not specified). No further details were provided. Additional information has been requested.
Age: 73.0
Sex: F
Vaccine: PPV
Symptoms: Injection site bruising, Laboratory test
Clinical narrative: Information has been received from a Licensed Practical Nurse (L.P.N.) concerning a 73 year old female with upper respiratory tract infection one and half week prior to the second vaccination with Pneumovax 23 and was treated with azithromycin (azithromycin) and "TAMIFLU". The patient received the first dose of Pneumovax 23 some time in nineteen seventies (date, month was not known). On 06-NOV-2007, the patient was vaccinated IM with a second dose of Pneumovax 23 lot # 658449/0989U. Concomitant therapy included levothyroxine Na, pravastatin Na (PRAVACHOL), ibandronate sodium (BONIVA), triamterene/HCTz, alprazolam (XANAX) and zolpidem tartrate (AMBIEN). On 07-NOV-2007, a day after she got her second injection the patient developed a bruise at the injection site. She was examined in the emergency room on 07-NOV-2007 and given intravenous (IV) antibiotics. She was not admitted but instead, she was released with oral antibiotics. On 08-NOV-2007 she was examined by her physician. No further information was available. The patient was recovering. The physician indicated that the patient getting intravenous (IV) antibiotics was an intervention to prevent a serious criteria and it was reported as an other medical event (OME). Additional information has been requested.
Age: 1.1
Sex: M
Vaccine: HEPA, MMR, VARCEL
Symptoms: Diarrhoea, Kawasaki's disease, Ocular hyperaemia, Pyrexia, Rash
Clinical narrative: Information has been received from a physician concerning a 13 month old 21 lb. 14 oz. male who on 02-OCT-2007, received his first dose subcutaneous in his right arm of MMR II (lot # 655383/1410). Concomitant vaccines included his first subcutaneous dose of Varivax (MSD) (lot#  658017/1071U) and a first intramuscular dose of (HAVRIX) (lot# AHAV3172BA). There was no reported illness at the time of the vaccinations." One week after the immunization" on 09-OCT-2007 he developed Kawasaki disease and was seen in the physician's office. Treatment and the current status of the patient was not reported. Follow up information from a physician concerning this 13 month old male reported that on 04-OCT-2007, he developed a high fever and red eyes that progressed to rash vomiting and diarrhea. On 08-OCT-2007 he was seen, diagnosed with Kawasaki syndrome, hospitalized for 2 days and treated with intravenous immunoglobulin (IVIG). It was reported that as of 11-OCT-2007 he had recovered. Additional information is not expected.
Age: 1.1
Sex: M
Vaccine: HEPA, MMR, VARCEL
Symptoms: Vomiting
Clinical narrative: Information has been received from a physician concerning a 13 month old 21 lb. 14 oz. male who on 02-OCT-2007, received his first dose subcutaneous in his right arm of MMR II (lot # 655383/1410). Concomitant vaccines included his first subcutaneous dose of Varivax (MSD) (lot#  658017/1071U) and a first intramuscular dose of (HAVRIX) (lot# AHAV3172BA). There was no reported illness at the time of the vaccinations." One week after the immunization" on 09-OCT-2007 he developed Kawasaki disease and was seen in the physician's office. Treatment and the current status of the patient was not reported. Follow up information from a physician concerning this 13 month old male reported that on 04-OCT-2007, he developed a high fever and red eyes that progressed to rash vomiting and diarrhea. On 08-OCT-2007 he was seen, diagnosed with Kawasaki syndrome, hospitalized for 2 days and treated with intravenous immunoglobulin (IVIG). It was reported that as of 11-OCT-2007 he had recovered. Additional information is not expected.
Age: 64.0
Sex: M
Vaccine: FLU3
Symptoms: Blood creatine phosphokinase increased, CSF protein increased, Demyelination, Electromyogram abnormal, Guillain-Barre syndrome
Clinical narrative: Demyelinating peripheral neuropathy compatible with Guillian-Barre Syndrome.  12/11/07 Reviewed hospital medical records which reveal patient experienced tingling & paresthesia of hands & feet starting approx 2 wks prior to admit & progressing to include lips & tongue.  Also developed balance & gait difficulty.  Denied any prior illness & had no problem w/flu shot in past.  Admitted 10/30-11/05/2007.  On admit, was areflexic & symmetrical sensory loss of UE & LE which worsened during hospitalization.  LP done.  Patient initially refused IVIG & plasmapheresis due to religious beliefs but during hospitalization did accept IVIG x 5 doses.  There was mild progression of weakness of LEs but no significant extension.  D/C to inpatient rehab. FINAL DX: demyelinating peripheral neuropathy c/w Guillain Barre syndrome.
Age: 64.0
Sex: M
Vaccine: FLU3
Symptoms: Lumbar puncture abnormal, Neuropathy peripheral
Clinical narrative: Demyelinating peripheral neuropathy compatible with Guillian-Barre Syndrome.  12/11/07 Reviewed hospital medical records which reveal patient experienced tingling & paresthesia of hands & feet starting approx 2 wks prior to admit & progressing to include lips & tongue.  Also developed balance & gait difficulty.  Denied any prior illness & had no problem w/flu shot in past.  Admitted 10/30-11/05/2007.  On admit, was areflexic & symmetrical sensory loss of UE & LE which worsened during hospitalization.  LP done.  Patient initially refused IVIG & plasmapheresis due to religious beliefs but during hospitalization did accept IVIG x 5 doses.  There was mild progression of weakness of LEs but no significant extension.  D/C to inpatient rehab. FINAL DX: demyelinating peripheral neuropathy c/w Guillain Barre syndrome.
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Asthenia, Auricular swelling, Blood electrolytes, Body temperature increased, Coagulation test
Clinical narrative: Pt. returned to vaccination site on 10/8/07 c/o Right ear swelling which began 10/6 and now also pain and drainage (Rt) ear. 3+ (Rt) tonsilar node. T99.2 p 68-Referred to Urgent Care Center since pt new to area and no PCP. Urgent Care Center 10/8 dxed Otitis Media with Adenopathy and Rxed with Augmentin. Returned to medical center ER on 10/9 c/o (Rt) facial pain,k, weakness, numbness, nausea, vomiting, vertigo, photophobia. CT scan no abnormalities. MRI confirmed exam for Ramsey Hunt Syndrome. She was high dose steroids, IV Acyclovir and Valium. Discharged 10/12/07. As 5/11/07 continued improvement. 11/20/07-record received for DOS 11/10-10/12/07-DC DX:Ramsay Hunt syndrome. Vesicles in right ear.C/O nausea, vomiting vertiginous feeling. Right cervical lymphadenopathy, painful with ear swelling right facial pain and subsequent numbness and weakness of upper and lower portions of face. Decreased sensation to both sides of face. Per 60 day follow up: When last spoke with her she was well on road to recovery, lost to followup.
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Computerised tomogram normal, Ear pain, Electrocardiogram, Electroencephalogram, Facial pain
Clinical narrative: Pt. returned to vaccination site on 10/8/07 c/o Right ear swelling which began 10/6 and now also pain and drainage (Rt) ear. 3+ (Rt) tonsilar node. T99.2 p 68-Referred to Urgent Care Center since pt new to area and no PCP. Urgent Care Center 10/8 dxed Otitis Media with Adenopathy and Rxed with Augmentin. Returned to medical center ER on 10/9 c/o (Rt) facial pain,k, weakness, numbness, nausea, vomiting, vertigo, photophobia. CT scan no abnormalities. MRI confirmed exam for Ramsey Hunt Syndrome. She was high dose steroids, IV Acyclovir and Valium. Discharged 10/12/07. As 5/11/07 continued improvement. 11/20/07-record received for DOS 11/10-10/12/07-DC DX:Ramsay Hunt syndrome. Vesicles in right ear.C/O nausea, vomiting vertiginous feeling. Right cervical lymphadenopathy, painful with ear swelling right facial pain and subsequent numbness and weakness of upper and lower portions of face. Decreased sensation to both sides of face. Per 60 day follow up: When last spoke with her she was well on road to recovery, lost to followup.
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Full blood count, Herpes zoster oticus, Hypoaesthesia, Liver function test, Nausea
Clinical narrative: Pt. returned to vaccination site on 10/8/07 c/o Right ear swelling which began 10/6 and now also pain and drainage (Rt) ear. 3+ (Rt) tonsilar node. T99.2 p 68-Referred to Urgent Care Center since pt new to area and no PCP. Urgent Care Center 10/8 dxed Otitis Media with Adenopathy and Rxed with Augmentin. Returned to medical center ER on 10/9 c/o (Rt) facial pain,k, weakness, numbness, nausea, vomiting, vertigo, photophobia. CT scan no abnormalities. MRI confirmed exam for Ramsey Hunt Syndrome. She was high dose steroids, IV Acyclovir and Valium. Discharged 10/12/07. As 5/11/07 continued improvement. 11/20/07-record received for DOS 11/10-10/12/07-DC DX:Ramsay Hunt syndrome. Vesicles in right ear.C/O nausea, vomiting vertiginous feeling. Right cervical lymphadenopathy, painful with ear swelling right facial pain and subsequent numbness and weakness of upper and lower portions of face. Decreased sensation to both sides of face. Per 60 day follow up: When last spoke with her she was well on road to recovery, lost to followup.
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Nuclear magnetic resonance imaging abnormal, Otitis media, Otorrhoea, Photophobia, Tonsillar hypertrophy
Clinical narrative: Pt. returned to vaccination site on 10/8/07 c/o Right ear swelling which began 10/6 and now also pain and drainage (Rt) ear. 3+ (Rt) tonsilar node. T99.2 p 68-Referred to Urgent Care Center since pt new to area and no PCP. Urgent Care Center 10/8 dxed Otitis Media with Adenopathy and Rxed with Augmentin. Returned to medical center ER on 10/9 c/o (Rt) facial pain,k, weakness, numbness, nausea, vomiting, vertigo, photophobia. CT scan no abnormalities. MRI confirmed exam for Ramsey Hunt Syndrome. She was high dose steroids, IV Acyclovir and Valium. Discharged 10/12/07. As 5/11/07 continued improvement. 11/20/07-record received for DOS 11/10-10/12/07-DC DX:Ramsay Hunt syndrome. Vesicles in right ear.C/O nausea, vomiting vertiginous feeling. Right cervical lymphadenopathy, painful with ear swelling right facial pain and subsequent numbness and weakness of upper and lower portions of face. Decreased sensation to both sides of face. Per 60 day follow up: When last spoke with her she was well on road to recovery, lost to followup.
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Vertigo, Vomiting
Clinical narrative: Pt. returned to vaccination site on 10/8/07 c/o Right ear swelling which began 10/6 and now also pain and drainage (Rt) ear. 3+ (Rt) tonsilar node. T99.2 p 68-Referred to Urgent Care Center since pt new to area and no PCP. Urgent Care Center 10/8 dxed Otitis Media with Adenopathy and Rxed with Augmentin. Returned to medical center ER on 10/9 c/o (Rt) facial pain,k, weakness, numbness, nausea, vomiting, vertigo, photophobia. CT scan no abnormalities. MRI confirmed exam for Ramsey Hunt Syndrome. She was high dose steroids, IV Acyclovir and Valium. Discharged 10/12/07. As 5/11/07 continued improvement. 11/20/07-record received for DOS 11/10-10/12/07-DC DX:Ramsay Hunt syndrome. Vesicles in right ear.C/O nausea, vomiting vertiginous feeling. Right cervical lymphadenopathy, painful with ear swelling right facial pain and subsequent numbness and weakness of upper and lower portions of face. Decreased sensation to both sides of face. Per 60 day follow up: When last spoke with her she was well on road to recovery, lost to followup.
Age: 68.0
Sex: M
Vaccine: FLU3
Symptoms: Full blood count, Gastrointestinal haemorrhage, Metabolic function test, Myalgia, Red blood cell sedimentation rate
Clinical narrative: 10/23/07 ER visit. 10/24/07 Doctor saw for bilateral arm and leg myalgia. Rx Oxycodone. 10/27/07 Doctor appointment for recheck; myalgia, labs drawn. 10/31 RNG saw for possible vasculitis. Patient told to continue on Prednisone. 11/09/07 RNG saw patient; admitted to hospital; GI bleed. 11/13/4 Doctor saw for GI bleed. Admitted for GI bleed.  12/17/2007 MR received for ER visit of 10/23/2007 with Dx: Myalgias.  Pt presented to ER with c/o cramping in the low back, starting at the buttocks and descending down to the calves. Cramping also noted in the biceps area. (+) fever and chills.  had similar muscle cramping with some past medications. Txd with pain meds and D/Cd.  Pt admitted 11/9-10/2007 with DX:  Acute GI bleed. Pt has been on prednisone recentlyand ASA and Plavix. Presented with melenic stools and coffee ground and fresh blood emesis. C/o lightheadedness and sweats.  Re-admitted 11/13-16/2007 with sx of dizziness with a Hgb of 7.3 following an upper GI bleed with ulcer. Hgb up to 8.2 after 2 units PRBCs. DX:  Acute blood loss anemia.  Possible GI Bleed.  Recent upper GI bleed.  Transfused 3 units during hospitalization with stablization of Hgb.  Known CAD, LAD drug eluting stent.  EGD showing healing ulcer.  Erythematous esophagus. Diverticulosis seen on colonoscopy.  Flat polyps, not biopsied.  Large hiatal hernia on prior EGD.  Free reflux on prior EGD, documented GERD.  Esophagitis. Gastric cardia nodule, biopsy OK.  Duodenal bulb based ulcer.  Protonix BID tx.  Plavix and ASA on hold.  Hypothyroid, on Synthroid, changed from dessicated thyroid recently.  Reaction to Flu vaccine with possible neuropathy, central vs peripheral.  Ongoing feet numbness and tingling fingers 2' to Flu vaccine.  Remote thyroidectomy.  Remote L breast CA.  Remote appendectomy.  Remote knee bone spur removal.  Remote umbilical hernia repair.  Family hx of throat CA and breast CA.  Ex-smoker.  Demerol and Flu shot allergies.
Age: 68.0
Sex: M
Vaccine: FLU3
Symptoms: Urine analysis, Vasculitis
Clinical narrative: 10/23/07 ER visit. 10/24/07 Doctor saw for bilateral arm and leg myalgia. Rx Oxycodone. 10/27/07 Doctor appointment for recheck; myalgia, labs drawn. 10/31 RNG saw for possible vasculitis. Patient told to continue on Prednisone. 11/09/07 RNG saw patient; admitted to hospital; GI bleed. 11/13/4 Doctor saw for GI bleed. Admitted for GI bleed.  12/17/2007 MR received for ER visit of 10/23/2007 with Dx: Myalgias.  Pt presented to ER with c/o cramping in the low back, starting at the buttocks and descending down to the calves. Cramping also noted in the biceps area. (+) fever and chills.  had similar muscle cramping with some past medications. Txd with pain meds and D/Cd.  Pt admitted 11/9-10/2007 with DX:  Acute GI bleed. Pt has been on prednisone recentlyand ASA and Plavix. Presented with melenic stools and coffee ground and fresh blood emesis. C/o lightheadedness and sweats.  Re-admitted 11/13-16/2007 with sx of dizziness with a Hgb of 7.3 following an upper GI bleed with ulcer. Hgb up to 8.2 after 2 units PRBCs. DX:  Acute blood loss anemia.  Possible GI Bleed.  Recent upper GI bleed.  Transfused 3 units during hospitalization with stablization of Hgb.  Known CAD, LAD drug eluting stent.  EGD showing healing ulcer.  Erythematous esophagus. Diverticulosis seen on colonoscopy.  Flat polyps, not biopsied.  Large hiatal hernia on prior EGD.  Free reflux on prior EGD, documented GERD.  Esophagitis. Gastric cardia nodule, biopsy OK.  Duodenal bulb based ulcer.  Protonix BID tx.  Plavix and ASA on hold.  Hypothyroid, on Synthroid, changed from dessicated thyroid recently.  Reaction to Flu vaccine with possible neuropathy, central vs peripheral.  Ongoing feet numbness and tingling fingers 2' to Flu vaccine.  Remote thyroidectomy.  Remote L breast CA.  Remote appendectomy.  Remote knee bone spur removal.  Remote umbilical hernia repair.  Family hx of throat CA and breast CA.  Ex-smoker.  Demerol and Flu shot allergies.
Age: 17.0
Sex: M
Vaccine: PPV
Symptoms: Erythema, Increased bronchial secretion, Induration, Injection site erythema, Injection site pain
Clinical narrative: Redness of right arm, fever, and increased secretion since 11/3/07. Patient seen in tech dependent clinic on 11/2. By Sunday November 4, the area was indurated red, and tender r/o evolving cellulitis.  12/14/07 Reviewed hospital medical records which reveal patient seen in clinic in usual state of health on 11/2/07 day of vax.  ER visit of 11/4/07 reveals patient experienced fever, wheezing, increased secretions.  There was swelling, tenderness & redness of the right arm where pneumo vax given. Admitted 11/4-11/7/2007 to PICU.  Tx w/IV antibiotics & nebs.  FINAL DX: Fever; local reaction to Pneumovax vaccine; and respiratory infection.  No D/C summary available, dates obtained verbally.
Age: 17.0
Sex: M
Vaccine: PPV
Symptoms: Pyrexia, Tenderness
Clinical narrative: Redness of right arm, fever, and increased secretion since 11/3/07. Patient seen in tech dependent clinic on 11/2. By Sunday November 4, the area was indurated red, and tender r/o evolving cellulitis.  12/14/07 Reviewed hospital medical records which reveal patient seen in clinic in usual state of health on 11/2/07 day of vax.  ER visit of 11/4/07 reveals patient experienced fever, wheezing, increased secretions.  There was swelling, tenderness & redness of the right arm where pneumo vax given. Admitted 11/4-11/7/2007 to PICU.  Tx w/IV antibiotics & nebs.  FINAL DX: Fever; local reaction to Pneumovax vaccine; and respiratory infection.  No D/C summary available, dates obtained verbally.
Age: 20.0
Sex: M
Vaccine: FLU3, IPV, MNQ, TD
Symptoms: Arthralgia, Basophil count normal, Biopsy skin normal, Blood calcium normal, Blood magnesium normal
Clinical narrative: pt received his meningitis, polio, influenza and Td vaccinations on the morning of 13 Oct 07. He reported no problems that day. On Sunday, he had his first PT without rolling or twisting his left ankle. He noted pain in his ankle when he tired to stand and he required assistance to return to room. When he got to his room, he noticed swelling on the outside of his left ankle and initially thought it was related to his PT earlier that day. He went to the emergency department in which he had a normal x-ray, and they tried to tap his ankle but did not get any fluid. Other than a low-grade fever, he denied any other symptoms. The swelling had decreased and on Monday morning, he was discharged with a posteror splint and non-weight bearing crutches. On the evening of the 15 he removed the wrap and splint and noticed that his entire foot and ankle was swollen, with decrease range of motion and discomfort. He did not notice swelling or discomfort during the day. He denied swelling above the level of his ankle. He returned to the emergency department Monday evening, in which he also noticed minimal swelling to his rt ankle and a small area of swelling on his rt knee. He was admitted and then on Tuesday morning he had developed spots on the top of his left foot only. He had no recall of fever or other symptoms. He was placed on vancomycin and soon afterwards began to develop redness, itching and hives on his upper body and scalp. The vancomycin was stopped and he was placed on steroids. He was discharged on Wednesday and has both dermatology and an allergy evaluation. The swelling quickly subsided within a couple of days and he was told he had a hypersensitivity immune reaction. Currently he has fully recovered without any residual effects. He has not returned to PT regime other than walking. He never had any problems like this in the past and stated he was a sprint runner during high school. He denies any problems with allergies or previous immunizations  01/14/2008 MR received for hospital DOS 10/15-17/2007 as well as F/u OVs as well as VHC eval 12/7/07. DX: Immune Hypersensitivity Reaction. Pt reported L foot swelling and pain.  Seen in ER and dxd with cellulitis.  Sx worsened despite abx and pt returned to ER 10/15/07 now with areas of erythema, warmth, and increased swelling and pain.  Allergic rxn to vanco in ER. Petechiae noted on feet as well as palmar erythema, and other areas of erythema and rash. R knee pain now noted. No response to abx, steroids started 10/16/07 with good response.  Resolution of sx by F/u 11/1/07.  Assessment: Dermatitis.
Age: 20.0
Sex: M
Vaccine: FLU3, IPV, MNQ, TD
Symptoms: Blood phosphorus normal, Blood potassium normal, Blood sodium normal, Blood urea normal, C-reactive protein increased
Clinical narrative: pt received his meningitis, polio, influenza and Td vaccinations on the morning of 13 Oct 07. He reported no problems that day. On Sunday, he had his first PT without rolling or twisting his left ankle. He noted pain in his ankle when he tired to stand and he required assistance to return to room. When he got to his room, he noticed swelling on the outside of his left ankle and initially thought it was related to his PT earlier that day. He went to the emergency department in which he had a normal x-ray, and they tried to tap his ankle but did not get any fluid. Other than a low-grade fever, he denied any other symptoms. The swelling had decreased and on Monday morning, he was discharged with a posteror splint and non-weight bearing crutches. On the evening of the 15 he removed the wrap and splint and noticed that his entire foot and ankle was swollen, with decrease range of motion and discomfort. He did not notice swelling or discomfort during the day. He denied swelling above the level of his ankle. He returned to the emergency department Monday evening, in which he also noticed minimal swelling to his rt ankle and a small area of swelling on his rt knee. He was admitted and then on Tuesday morning he had developed spots on the top of his left foot only. He had no recall of fever or other symptoms. He was placed on vancomycin and soon afterwards began to develop redness, itching and hives on his upper body and scalp. The vancomycin was stopped and he was placed on steroids. He was discharged on Wednesday and has both dermatology and an allergy evaluation. The swelling quickly subsided within a couple of days and he was told he had a hypersensitivity immune reaction. Currently he has fully recovered without any residual effects. He has not returned to PT regime other than walking. He never had any problems like this in the past and stated he was a sprint runner during high school. He denies any problems with allergies or previous immunizations  01/14/2008 MR received for hospital DOS 10/15-17/2007 as well as F/u OVs as well as VHC eval 12/7/07. DX: Immune Hypersensitivity Reaction. Pt reported L foot swelling and pain.  Seen in ER and dxd with cellulitis.  Sx worsened despite abx and pt returned to ER 10/15/07 now with areas of erythema, warmth, and increased swelling and pain.  Allergic rxn to vanco in ER. Petechiae noted on feet as well as palmar erythema, and other areas of erythema and rash. R knee pain now noted. No response to abx, steroids started 10/16/07 with good response.  Resolution of sx by F/u 11/1/07.  Assessment: Dermatitis.
Age: 20.0
Sex: M
Vaccine: FLU3, IPV, MNQ, TD
Symptoms: Complement factor, Discomfort, Eosinophil count normal, Erythema, Gait disturbance
Clinical narrative: pt received his meningitis, polio, influenza and Td vaccinations on the morning of 13 Oct 07. He reported no problems that day. On Sunday, he had his first PT without rolling or twisting his left ankle. He noted pain in his ankle when he tired to stand and he required assistance to return to room. When he got to his room, he noticed swelling on the outside of his left ankle and initially thought it was related to his PT earlier that day. He went to the emergency department in which he had a normal x-ray, and they tried to tap his ankle but did not get any fluid. Other than a low-grade fever, he denied any other symptoms. The swelling had decreased and on Monday morning, he was discharged with a posteror splint and non-weight bearing crutches. On the evening of the 15 he removed the wrap and splint and noticed that his entire foot and ankle was swollen, with decrease range of motion and discomfort. He did not notice swelling or discomfort during the day. He denied swelling above the level of his ankle. He returned to the emergency department Monday evening, in which he also noticed minimal swelling to his rt ankle and a small area of swelling on his rt knee. He was admitted and then on Tuesday morning he had developed spots on the top of his left foot only. He had no recall of fever or other symptoms. He was placed on vancomycin and soon afterwards began to develop redness, itching and hives on his upper body and scalp. The vancomycin was stopped and he was placed on steroids. He was discharged on Wednesday and has both dermatology and an allergy evaluation. The swelling quickly subsided within a couple of days and he was told he had a hypersensitivity immune reaction. Currently he has fully recovered without any residual effects. He has not returned to PT regime other than walking. He never had any problems like this in the past and stated he was a sprint runner during high school. He denies any problems with allergies or previous immunizations  01/14/2008 MR received for hospital DOS 10/15-17/2007 as well as F/u OVs as well as VHC eval 12/7/07. DX: Immune Hypersensitivity Reaction. Pt reported L foot swelling and pain.  Seen in ER and dxd with cellulitis.  Sx worsened despite abx and pt returned to ER 10/15/07 now with areas of erythema, warmth, and increased swelling and pain.  Allergic rxn to vanco in ER. Petechiae noted on feet as well as palmar erythema, and other areas of erythema and rash. R knee pain now noted. No response to abx, steroids started 10/16/07 with good response.  Resolution of sx by F/u 11/1/07.  Assessment: Dermatitis.
Age: 20.0
Sex: M
Vaccine: FLU3, IPV, MNQ, TD
Symptoms: Haematocrit decreased, Haemoglobin decreased, Hypersensitivity, Joint range of motion decreased, Joint swelling
Clinical narrative: pt received his meningitis, polio, influenza and Td vaccinations on the morning of 13 Oct 07. He reported no problems that day. On Sunday, he had his first PT without rolling or twisting his left ankle. He noted pain in his ankle when he tired to stand and he required assistance to return to room. When he got to his room, he noticed swelling on the outside of his left ankle and initially thought it was related to his PT earlier that day. He went to the emergency department in which he had a normal x-ray, and they tried to tap his ankle but did not get any fluid. Other than a low-grade fever, he denied any other symptoms. The swelling had decreased and on Monday morning, he was discharged with a posteror splint and non-weight bearing crutches. On the evening of the 15 he removed the wrap and splint and noticed that his entire foot and ankle was swollen, with decrease range of motion and discomfort. He did not notice swelling or discomfort during the day. He denied swelling above the level of his ankle. He returned to the emergency department Monday evening, in which he also noticed minimal swelling to his rt ankle and a small area of swelling on his rt knee. He was admitted and then on Tuesday morning he had developed spots on the top of his left foot only. He had no recall of fever or other symptoms. He was placed on vancomycin and soon afterwards began to develop redness, itching and hives on his upper body and scalp. The vancomycin was stopped and he was placed on steroids. He was discharged on Wednesday and has both dermatology and an allergy evaluation. The swelling quickly subsided within a couple of days and he was told he had a hypersensitivity immune reaction. Currently he has fully recovered without any residual effects. He has not returned to PT regime other than walking. He never had any problems like this in the past and stated he was a sprint runner during high school. He denies any problems with allergies or previous immunizations  01/14/2008 MR received for hospital DOS 10/15-17/2007 as well as F/u OVs as well as VHC eval 12/7/07. DX: Immune Hypersensitivity Reaction. Pt reported L foot swelling and pain.  Seen in ER and dxd with cellulitis.  Sx worsened despite abx and pt returned to ER 10/15/07 now with areas of erythema, warmth, and increased swelling and pain.  Allergic rxn to vanco in ER. Petechiae noted on feet as well as palmar erythema, and other areas of erythema and rash. R knee pain now noted. No response to abx, steroids started 10/16/07 with good response.  Resolution of sx by F/u 11/1/07.  Assessment: Dermatitis.
Age: 20.0
Sex: M
Vaccine: FLU3, IPV, MNQ, TD
Symptoms: Lymphocyte count normal, Monocyte count increased, Neutrophil count normal, Petechiae, Platelet count normal
Clinical narrative: pt received his meningitis, polio, influenza and Td vaccinations on the morning of 13 Oct 07. He reported no problems that day. On Sunday, he had his first PT without rolling or twisting his left ankle. He noted pain in his ankle when he tired to stand and he required assistance to return to room. When he got to his room, he noticed swelling on the outside of his left ankle and initially thought it was related to his PT earlier that day. He went to the emergency department in which he had a normal x-ray, and they tried to tap his ankle but did not get any fluid. Other than a low-grade fever, he denied any other symptoms. The swelling had decreased and on Monday morning, he was discharged with a posteror splint and non-weight bearing crutches. On the evening of the 15 he removed the wrap and splint and noticed that his entire foot and ankle was swollen, with decrease range of motion and discomfort. He did not notice swelling or discomfort during the day. He denied swelling above the level of his ankle. He returned to the emergency department Monday evening, in which he also noticed minimal swelling to his rt ankle and a small area of swelling on his rt knee. He was admitted and then on Tuesday morning he had developed spots on the top of his left foot only. He had no recall of fever or other symptoms. He was placed on vancomycin and soon afterwards began to develop redness, itching and hives on his upper body and scalp. The vancomycin was stopped and he was placed on steroids. He was discharged on Wednesday and has both dermatology and an allergy evaluation. The swelling quickly subsided within a couple of days and he was told he had a hypersensitivity immune reaction. Currently he has fully recovered without any residual effects. He has not returned to PT regime other than walking. He never had any problems like this in the past and stated he was a sprint runner during high school. He denies any problems with allergies or previous immunizations  01/14/2008 MR received for hospital DOS 10/15-17/2007 as well as F/u OVs as well as VHC eval 12/7/07. DX: Immune Hypersensitivity Reaction. Pt reported L foot swelling and pain.  Seen in ER and dxd with cellulitis.  Sx worsened despite abx and pt returned to ER 10/15/07 now with areas of erythema, warmth, and increased swelling and pain.  Allergic rxn to vanco in ER. Petechiae noted on feet as well as palmar erythema, and other areas of erythema and rash. R knee pain now noted. No response to abx, steroids started 10/16/07 with good response.  Resolution of sx by F/u 11/1/07.  Assessment: Dermatitis.
Age: 20.0
Sex: M
Vaccine: FLU3, IPV, MNQ, TD
Symptoms: Pruritus, Pyrexia, Rash, Red blood cell count decreased, Red blood cell sedimentation rate normal
Clinical narrative: pt received his meningitis, polio, influenza and Td vaccinations on the morning of 13 Oct 07. He reported no problems that day. On Sunday, he had his first PT without rolling or twisting his left ankle. He noted pain in his ankle when he tired to stand and he required assistance to return to room. When he got to his room, he noticed swelling on the outside of his left ankle and initially thought it was related to his PT earlier that day. He went to the emergency department in which he had a normal x-ray, and they tried to tap his ankle but did not get any fluid. Other than a low-grade fever, he denied any other symptoms. The swelling had decreased and on Monday morning, he was discharged with a posteror splint and non-weight bearing crutches. On the evening of the 15 he removed the wrap and splint and noticed that his entire foot and ankle was swollen, with decrease range of motion and discomfort. He did not notice swelling or discomfort during the day. He denied swelling above the level of his ankle. He returned to the emergency department Monday evening, in which he also noticed minimal swelling to his rt ankle and a small area of swelling on his rt knee. He was admitted and then on Tuesday morning he had developed spots on the top of his left foot only. He had no recall of fever or other symptoms. He was placed on vancomycin and soon afterwards began to develop redness, itching and hives on his upper body and scalp. The vancomycin was stopped and he was placed on steroids. He was discharged on Wednesday and has both dermatology and an allergy evaluation. The swelling quickly subsided within a couple of days and he was told he had a hypersensitivity immune reaction. Currently he has fully recovered without any residual effects. He has not returned to PT regime other than walking. He never had any problems like this in the past and stated he was a sprint runner during high school. He denies any problems with allergies or previous immunizations  01/14/2008 MR received for hospital DOS 10/15-17/2007 as well as F/u OVs as well as VHC eval 12/7/07. DX: Immune Hypersensitivity Reaction. Pt reported L foot swelling and pain.  Seen in ER and dxd with cellulitis.  Sx worsened despite abx and pt returned to ER 10/15/07 now with areas of erythema, warmth, and increased swelling and pain.  Allergic rxn to vanco in ER. Petechiae noted on feet as well as palmar erythema, and other areas of erythema and rash. R knee pain now noted. No response to abx, steroids started 10/16/07 with good response.  Resolution of sx by F/u 11/1/07.  Assessment: Dermatitis.
Age: 20.0
Sex: M
Vaccine: FLU3, IPV, MNQ, TD
Symptoms: Streptococcal identification test, Swelling, Urticaria, White blood cell count normal
Clinical narrative: pt received his meningitis, polio, influenza and Td vaccinations on the morning of 13 Oct 07. He reported no problems that day. On Sunday, he had his first PT without rolling or twisting his left ankle. He noted pain in his ankle when he tired to stand and he required assistance to return to room. When he got to his room, he noticed swelling on the outside of his left ankle and initially thought it was related to his PT earlier that day. He went to the emergency department in which he had a normal x-ray, and they tried to tap his ankle but did not get any fluid. Other than a low-grade fever, he denied any other symptoms. The swelling had decreased and on Monday morning, he was discharged with a posteror splint and non-weight bearing crutches. On the evening of the 15 he removed the wrap and splint and noticed that his entire foot and ankle was swollen, with decrease range of motion and discomfort. He did not notice swelling or discomfort during the day. He denied swelling above the level of his ankle. He returned to the emergency department Monday evening, in which he also noticed minimal swelling to his rt ankle and a small area of swelling on his rt knee. He was admitted and then on Tuesday morning he had developed spots on the top of his left foot only. He had no recall of fever or other symptoms. He was placed on vancomycin and soon afterwards began to develop redness, itching and hives on his upper body and scalp. The vancomycin was stopped and he was placed on steroids. He was discharged on Wednesday and has both dermatology and an allergy evaluation. The swelling quickly subsided within a couple of days and he was told he had a hypersensitivity immune reaction. Currently he has fully recovered without any residual effects. He has not returned to PT regime other than walking. He never had any problems like this in the past and stated he was a sprint runner during high school. He denies any problems with allergies or previous immunizations  01/14/2008 MR received for hospital DOS 10/15-17/2007 as well as F/u OVs as well as VHC eval 12/7/07. DX: Immune Hypersensitivity Reaction. Pt reported L foot swelling and pain.  Seen in ER and dxd with cellulitis.  Sx worsened despite abx and pt returned to ER 10/15/07 now with areas of erythema, warmth, and increased swelling and pain.  Allergic rxn to vanco in ER. Petechiae noted on feet as well as palmar erythema, and other areas of erythema and rash. R knee pain now noted. No response to abx, steroids started 10/16/07 with good response.  Resolution of sx by F/u 11/1/07.  Assessment: Dermatitis.
Age: 0.2
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Death
Clinical narrative: received phone call that infant had expired.  2/5/08 Reviewed Autopsy Report & death certificate which accompanied autopsy report which states COD consistent w/Sudden Infant Death Syndrome (Group B) in co-sleeping infant.  Findings included: sudden death in 2 mo old co-sleeping infant; hx of parental drug abuse (opiates per parents); post mortem tox exam neg for drugs or alcohol; hx of preemie, 36 wk, 5 lbs, 4 oz.
Age: 16.0
Sex: M
Vaccine: FLUN3
Symptoms: Erythema, Pruritus, Rash generalised, Urticaria
Clinical narrative: Patient complained of itchy, red, raised bumps over entire body except face 28 hr after Flu-Mist dose. Hives were relieved by single adult dose of Tylenol- Allergy medication but itchiness persisted x 1d until given 50mg. Benadryl. Patient denies any respiratory involvement. Hives recurred on 3rd and 4th day with decreasing intensity and released each time by 50mg. Benadryl. No incidence reported for days 5-10. No medical attention sought.
Age: 1.3
Sex: F
Vaccine: DTAP, FLU3
Symptoms: Lymphadenopathy
Clinical narrative: Lymphadenopathy - neck
Age: 8.0
Sex: M
Vaccine: FLU3
Symptoms: Activated partial thromboplastin time normal, Basophil count decreased, Eosinophil percentage, Haematocrit normal, Haemoglobin normal
Clinical narrative: At the time of the vaccine there was reported a lot bleeding about 24 hrs after receiving the vaccine, the area seemed to small onset warmer that was still present at 98hrs
Age: 8.0
Sex: M
Vaccine: FLU3
Symptoms: Haemorrhage, International normalised ratio, Lymphocyte percentage, Mean cell haemoglobin, Mean cell haemoglobin concentration
Clinical narrative: At the time of the vaccine there was reported a lot bleeding about 24 hrs after receiving the vaccine, the area seemed to small onset warmer that was still present at 98hrs
Age: 8.0
Sex: M
Vaccine: FLU3
Symptoms: Mean cell volume normal, Monocyte percentage, Neutrophil percentage, Platelet count normal, Red blood cell count normal
Clinical narrative: At the time of the vaccine there was reported a lot bleeding about 24 hrs after receiving the vaccine, the area seemed to small onset warmer that was still present at 98hrs
Age: 8.0
Sex: M
Vaccine: FLU3
Symptoms: Red cell distribution width decreased, Skin warm, White blood cell count
Clinical narrative: At the time of the vaccine there was reported a lot bleeding about 24 hrs after receiving the vaccine, the area seemed to small onset warmer that was still present at 98hrs
Age: 72.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Pain in extremity
Clinical narrative: Right Arm turned red underneath running up toward the lymph nodes in the arm pit. Arm was sore