Age: 14.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Muscular weakness, Nausea, Nervous system disorder, Neurological examination abnormal, Nuclear magnetic resonance imaging normal
Clinical narrative: Wrong shot given 12/26/08 (another meningitis shot given, instead of HPV #3).  1/6/09, upper respiratory infection, headache. 1/14/09 headaches worsen. Respiratory cleared up with antibiotics/looked like pneumonia. 1/15/09 dizziness. 1/28/09, headaches spike to levels 5-7 out of 10, 100% of the time. Ibuprofen does not work (800 mg). Mid feb: saw dr. Augmentum given for possible sinus infection. Headaches worsen, nasal fluid leakage continues. Augmentum does nothing. CAT scan MRI to be ordered within 5 days of Augmentum. Headaches spike to 7-8 100% of the time. Dizzy, no focus, loss of memory. Removed from school. Saw chiropractor - no one could touch the back of her head (meninga area) without her screaming. Says her head feels swollen and numb. Spine starts to burn. 2/15/09 8 pm, headaches go to 10/10, patient screaming. Consider possibility of brain tumor and take her to ER. Has trouble walking in straight line. CAT scan ordered by ER. Doctor send her home and tells her to take 2 Tylenols and 3 ibuprofens. CAT scan normal. 2/17 saw pediatrician again. Full blood work ordered: tests vitamin D, thyroid function, regular bloodwork. Referred to neurologist. 2/19/09 Dr. agrees problem could have been caused by cross reactions of Gardasil and Menactra: gives her Topomax at 50 mg/day and orders MRI.  2/20/09: MRI looks normal. Spine still burning, back of head untouchable, having more touble walking in a straight line.  2/23/09 2nd day of Topomax. Can only walk in 45 degree angles....cannot walk to bathroom. Go to ER, where she is seen by a team on neurologists and admitted to hospital for next 3 days. Ibuprofen administered via IV. No repsonse. 2nd day: DHE administered, which takes effect and after 3rd day she is released.  March and April '09: patient can get through 2-4 hours of school each day and in the midst of that, needs a 1 hour rest on couch in office at school. Most days I pick her up at lunch. She is pale and very dizzy, with headaches reoccurring daily. Typically levels 4-5, with 7-8 spikes. She loses 8 lbs (she weighs 104). Picks up a flu bug and end of March due to compromised immune system. Follow up with neurology to see if she has cerebral leakage, as she is complaining of a "dripping" sensation in back of head.  End April: Heart palpitations begin, cramping of upper left chest area starts. Topomax reduced to 15 mg, but headaches continue. Does not finish 9th grade. Sleeps all night and approx 6 hours during the day. Starts complaining of breathing problems, as if not getting enough O2. May-July: headaches, dizziness, spine burning, memory loss, breathing issues continue. 2/3 of her hair falls out and hand tremors begin. Can't work for maore than 2 hours/day on school work (to finish 9th grade.)  July 2009: start her on Eastern medical practices: foot zoning (similar to reflexology) every 2 days. This helps her tremendously, but makes her nauseated. Arteries and veins in legs begin burning to level of pain where she is screaming.   August 2009: goes to high school 1/2 time...contracts Mono almost immediately. Red rash sets in all over her face and upper torso.  Mid-Sept - October 31, 2009: Heart palpitations severe enough to cause new doctor to send her back to Hospital to have heart monitored and a heart exam. Is seen at home by nurse teacher weekly. Take her out of high school Nov. 1 2009 and into Online HS full time. Tremors continue, hair still falling out. Thyroid tested again: all normal.  Recovers from Mono, but arteries and veins in legs start to burn again. Level 8-10/ she sits on couch and screams, holding her legs.  Put her on Mangosteen/Xango juice to reduce inflammation. This works and pain subsides to manageable level. Memory loss still apparent, but focus improving. Cannot exercise for more than 20 mins at a time at a slow walking pace. Cannot continue playing soccer or refereeing or ballet. Drops all sports. Cannot walk more than .25 miles without being fatigued. Have her on mild exercise program. Stabilizes at 104 lbs...5'6". Considering possible adrenal gland failure?  April 2010: hearing loss in left ear. Continued weakness in legs. Still gets occassional hand tremors, hands sweat a lot. Hands and feet get very cold while body gets very warm. Continued inability to fuly focus for any length of time. (Before this, patient was a straight A, 4.0 very active in sports, student).  Has major short term memory loss. Has a tingling or burning sensations in legs, but at a manegable level except after standing more than 2 hours, it is unbearable and she sleeps for the next 4-6 hours. Now has eating issues: either eats a lot or won't eat at all for days due to lack of appetite. NOSE IS ALWAYS RUNNING SINCE JANUARY 2009. Still has bouts of dizziness, and is not permitted to drive. Menstrual cycle was normal before the shot, and then went away and became very irregular over the year.  Heart palpitations continue.  Nervous system seems to degrading. Her nerves will pinch unexpectadly, or if she hits a nerve in one area, a different part of her body will react in extreme pain. Hair starting to grow back.