chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 34.0
Sex: M
Vaccine: TD, TD
Symptoms: Rotator cuff syndrome
Clinical narrative: Initial report received on 16 August 2007 from a health care professional. A 34 year old male patient received on 06 August 2007 a dose of Decavac (lot# U1944DA), intramuscular into the left deltoid. On 07 August 2007, one day later, he experienced left shoulder severe pain and inflammation in joint. The patient received "prednisone shots". Relevant diagnostic tests was not available. The patient did not receive any other concomitant vaccination. Concomitant medications included Advil, as needed (PRN). The patient's ongoing illness included a laceration of middle finger. The patient did not have any adverse event following prior vaccination. The patient had not recovered. Follow-up information received on 15 January 2008 from a health care professional. The route and site of administration were reported as intramuscular and shoulder. Per the reporter, the vaccine was administered high, possibly into the shoulder bursa. The patient now has rotator cuff involvement and pain. At the time of this report, the patient had not recovered. Follow-up information was received from the health professional on 17 January 2008. based upon this new information, it was determined that the event meets the seriousness criteria for "Other - medically significant". In light of this new information, the case has been upgraded to serious. The patient received Decavac in the left shoulder, and immediately developed pain and discomfort at the injection site, along with an area of induration approximately the size of a "50-cent piece". An MRI revealed an edematous rotator cuff. Since the, he had been treated with several courses of prednisone, local injections of kenalog into the bursa and muscle tendon, and oral decadron. He also underwent physical therapy. Per the reporter, the patient had experienced increased range of motion and decreased pain after initiating therapy with decadron.
Sex: F
Vaccine: PER
Symptoms: Cardiomegaly
Clinical narrative: SERIOUSNESS: OTHER - MEDICALLY SIGNIFICANT. Initial report received on 23 January 2008 from another manufacturer who received the report from a physician. A physician reported that a female patient had developed "cardiomegally" after receiving a pertussis vaccine (brand and manufacturer unknown) "years and years ago". The patient was a female in her late teens or early twenties and had received treatment of the event however the reporter could not recall who the patient was. Information regarding who administered the vaccine and the vaccine manufacturer was unknown. No further information was provided.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Bursa disorder, Bursitis, C-reactive protein increased, Differential white blood cell count normal, Full blood count normal
Clinical narrative: SERIOUSNESS: OTHER - MEDICALLY SIGNIFICANT.  Initial report received on 06 November 2007 from a health care professional.  A 52-year-old female patient, with a history of allergic rhinitis and glaucoma, had received a right deltoid, intramuscular injection of Fluzone SV 2007-2008, lot number not reported, on 25 October 2007.  Immediately post-vaccination, the patient developed a sore, painful arm.  The patient was examined by a physician 11 days later and was experiencing an inflamed subacromial bursa.  Per the reporter, it appeared that the vaccination had been given very high, "possibly into the acromium process."  C-reactive protein was four times the normal limit.  At the time of this report, the patient had not recovered.  Follow-up information was received on 22 January 2008 from a health care professional.  After review of the case, it was decided to upgrade the case to serious due to the patient's persistent pain.  The lot number of Fluzone received by the patient was U24978A, expiration date 30 June 2008.  Laboratory test results (date not specified) included Sed rate (7), CBC differential (normal), CRP (4.1 to 3.7).  According to the reporter, the vaccination had likely been injected into the subacromial and subdeltoid bursa.  The patient was diagnosed with suspected subacromial bursal injection of Flu vaccine with sterile bursitis.  Corrective treatments included NSAIDs (not specified) and a follow-up consult with an orthopedic physician who administered a subacromial steroid injection.  The patient showed some improvement after the subacromial steroid injection but had not yet recovered from the event.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Immediate post-injection reaction, Inflammation, Pain in extremity, Red blood cell sedimentation rate increased, Wrong technique in drug usage process
Clinical narrative: SERIOUSNESS: OTHER - MEDICALLY SIGNIFICANT.  Initial report received on 06 November 2007 from a health care professional.  A 52-year-old female patient, with a history of allergic rhinitis and glaucoma, had received a right deltoid, intramuscular injection of Fluzone SV 2007-2008, lot number not reported, on 25 October 2007.  Immediately post-vaccination, the patient developed a sore, painful arm.  The patient was examined by a physician 11 days later and was experiencing an inflamed subacromial bursa.  Per the reporter, it appeared that the vaccination had been given very high, "possibly into the acromium process."  C-reactive protein was four times the normal limit.  At the time of this report, the patient had not recovered.  Follow-up information was received on 22 January 2008 from a health care professional.  After review of the case, it was decided to upgrade the case to serious due to the patient's persistent pain.  The lot number of Fluzone received by the patient was U24978A, expiration date 30 June 2008.  Laboratory test results (date not specified) included Sed rate (7), CBC differential (normal), CRP (4.1 to 3.7).  According to the reporter, the vaccination had likely been injected into the subacromial and subdeltoid bursa.  The patient was diagnosed with suspected subacromial bursal injection of Flu vaccine with sterile bursitis.  Corrective treatments included NSAIDs (not specified) and a follow-up consult with an orthopedic physician who administered a subacromial steroid injection.  The patient showed some improvement after the subacromial steroid injection but had not yet recovered from the event.
Age: 31.0
Sex: F
Vaccine: FLU3
Symptoms: Cough, Dyspnoea, Erythema, Induration, Pain
Clinical narrative: Information was received on 22 January 2008 from a literature article.  A portion of this article is verbatim and is in quotes.  "Thimerosal is a mercury derivative used as a preservative and bacteriostatic agent.  We report an immediate hypersensitivity reaction after skin testing with an adult influenza vaccine that seems to be due to thimerosal.  The patient is a 31-year-old woman with seasonal allergic rhinitis and irritable bowel syndrome.  She developed conjunctival erythema and local pain after using a thimerosal containing contact lens solution 15 years before the evaluation.  She then switched to and tolerated the same brand of contact lens solution without thimerosal.  She received a booster dose of tetanus toxoid (0.05mg of thimerosal per 0.5 mL dose) 2 1/2 years before this evaluation without any difficulty.  Because of her concerns regarding thimerosal, she received a thimerosal-free pediatric influenza vaccine 4 months earlier with no adverse events."  "A skin prick test using the full-strength adult influenza vaccine (25mg of thimerosal per 0.5 mL dose) generated a wheel consisting of a 3-mm induration with 25 mm of erythema with satellite lesions.  Within 20 minutes, the patient developed generalized pruritus without hives, throat tightness, and a dry cough without wheezing on auscultation.  Although her vital signs were stable, she was diffusely pruritic and short of breath.  She was treated with 0.3 mL of epinephrine intramuscularly and 180 mg of fexofenadine orally.  All symptoms resolved within 10 minutes."  The patient returned two months later for a second set of skin prick tests with Pediatric Fluzone vaccine (Thimerosal-free), Tetanus toxoid vaccine (manufacturer Sanofi Pasteur), and Decavac vaccine.  The testing included histamine control and saline glycerol control.  No noteable reaction was observed.  Per the reporter, the patient's reaction was directly observed; and there were no confounding ingestants.  Second, there was documented immediate hypersensitivity reaction to the vaccine containing thimerosal, and lack of a reaction to a similar vaccine without thimerosal.  "Owing to the patient's history of contact sensitivity to thimerosal, the temporal relationship between skin testing with the adult vaccine and the clinically obvious reaction, and the otherwise similar constituents of the adult and pediatric vaccines, we postulate that this reaction was an IgE-mediated immediate hypersensitivity reaction to the thimerosal in the vaccine and that thimerosal probably acts as hapten.  However, this was not formally proved by invitro IgE measurements, and therefore, a non-IgE mechanism is possible."  Per the reporter, it is believed that the patient tolerated earlier exposure to the tetanus vaccine and did not have skin test reactivity to the tetanus vaccine because the dose of thimerosal was much less than in the adult influenza vaccine (0.05 vs 25mg).
Age: 31.0
Sex: F
Vaccine: FLU3
Symptoms: Pruritus, Throat tightness, Urticaria
Clinical narrative: Information was received on 22 January 2008 from a literature article.  A portion of this article is verbatim and is in quotes.  "Thimerosal is a mercury derivative used as a preservative and bacteriostatic agent.  We report an immediate hypersensitivity reaction after skin testing with an adult influenza vaccine that seems to be due to thimerosal.  The patient is a 31-year-old woman with seasonal allergic rhinitis and irritable bowel syndrome.  She developed conjunctival erythema and local pain after using a thimerosal containing contact lens solution 15 years before the evaluation.  She then switched to and tolerated the same brand of contact lens solution without thimerosal.  She received a booster dose of tetanus toxoid (0.05mg of thimerosal per 0.5 mL dose) 2 1/2 years before this evaluation without any difficulty.  Because of her concerns regarding thimerosal, she received a thimerosal-free pediatric influenza vaccine 4 months earlier with no adverse events."  "A skin prick test using the full-strength adult influenza vaccine (25mg of thimerosal per 0.5 mL dose) generated a wheel consisting of a 3-mm induration with 25 mm of erythema with satellite lesions.  Within 20 minutes, the patient developed generalized pruritus without hives, throat tightness, and a dry cough without wheezing on auscultation.  Although her vital signs were stable, she was diffusely pruritic and short of breath.  She was treated with 0.3 mL of epinephrine intramuscularly and 180 mg of fexofenadine orally.  All symptoms resolved within 10 minutes."  The patient returned two months later for a second set of skin prick tests with Pediatric Fluzone vaccine (Thimerosal-free), Tetanus toxoid vaccine (manufacturer Sanofi Pasteur), and Decavac vaccine.  The testing included histamine control and saline glycerol control.  No noteable reaction was observed.  Per the reporter, the patient's reaction was directly observed; and there were no confounding ingestants.  Second, there was documented immediate hypersensitivity reaction to the vaccine containing thimerosal, and lack of a reaction to a similar vaccine without thimerosal.  "Owing to the patient's history of contact sensitivity to thimerosal, the temporal relationship between skin testing with the adult vaccine and the clinically obvious reaction, and the otherwise similar constituents of the adult and pediatric vaccines, we postulate that this reaction was an IgE-mediated immediate hypersensitivity reaction to the thimerosal in the vaccine and that thimerosal probably acts as hapten.  However, this was not formally proved by invitro IgE measurements, and therefore, a non-IgE mechanism is possible."  Per the reporter, it is believed that the patient tolerated earlier exposure to the tetanus vaccine and did not have skin test reactivity to the tetanus vaccine because the dose of thimerosal was much less than in the adult influenza vaccine (0.05 vs 25mg).
Age: 0.3
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC, RV5
Symptoms: Gastroenteritis
Clinical narrative: After oral Rotavirus - given at 4 month check up developed Acute Gastroentitis.  Hospitalized IV hydration (1-22-07 to 1-23-07).   2/8/08 Received vax record & database updated w/additional vax.  Pt in usual state of health on day of vax.  2/8/08 Received hospital d/c summary which reveals patient experienced vomiting, reduced oral intake & urine output x 1 day.  Admitted 11/22-11/23/2007.  Vomiting resolved & feeding returned to normal but on day of d/c developed foul smelling diarrhea FINAL DX: dehydration; gastroenteritis; vomiting; incidental finding of left kidney pelviectasis.
Age: 58.0
Sex: F
Vaccine: TD
Symptoms: Angioedema, Face oedema, Pruritus, Urticaria
Clinical narrative: Facial edema (angioedema), mild, urticaria of arm, legs, pruritus.
Age: 26.0
Sex: F
Vaccine: IPV, JEV, TYP
Symptoms: Allergy to vaccine, Hypersensitivity, Lip swelling, Tryptase, Urticaria
Clinical narrative: Patient admitted for observation after allergic reaction to vaccine.  Her reaction consisted of hives and lip swelling, and she received one dose of epinephrine in the clinic, followed by prednisone and antihistamines.  No worsening of her symptoms and resolution of her hives overnight.  Symptoms: Hives, Swelling of lips.  02/04/2008 MR received from reporter for o/n ER observation 1/31-2/1/2008 for allergic reaction to vaccine (probably Japanese Encephalitis, but Typhoid and IPV could not be excluded).  Pt developed a non-pruritic rash, facial flushing and H/A within minutes of receiving vax. Pt given epi and Benadryl and sent to ER for observation.  Approx 1 1/2 hours later the pt developed lip and tongue swelling w/o respiratory distress. Stable o/n and D/Cd with Epipen, antihistamines and prednisone. Per TC with reporter, pt presented again to ER on 2/4/08.   03/03/2008 Additional records received describing a "rebound" anaphylaxis from above incident on 2/4/08.  Pt began to feel malaise, then developed chest tightness and flushing. A splotchy rash developed which was itchy. (+) lip and hand swelling, increased RR and tingling of hands. Pt txd with steroids, benadryl, and zantac and admitted for observation o/n. No further sx.
Age: 2.0
Sex: F
Vaccine: FLUX
Symptoms: Incorrect dose administered, Medication error
Clinical narrative: 2-year-old received double the dose of flu vaccine.  Received 0.5 mL, should have received 0.25 mL.  This was her second scheduled dose.  Just occurred, awaiting return call from pediatrician regarding what to do.  Nurse administering could have been distracted, 5 children to do at same time.  Immediately after administration, nurse realized she grabbed the wrong syringe.
Age: 68.0
Sex: F
Vaccine: FLU3
Symptoms: Back pain, Pain in extremity, Physiotherapy, Skin warm, X-ray
Clinical narrative: 11/02/07 - Severe pain Lt arm, shoulder and now down back.  Warm arm.  Got pain med at ER.  Referral to ortho MD who took X-Ray.  Dx - unable to read.  To have ultra sound.
Age: 0.6
Sex: M
Vaccine: DTAP, HBHEPB, PNC, RV5
Symptoms: Body temperature increased, Vomiting
Clinical narrative: Vomiting, high temperature.  Vaccine was recalled by manufacturer.
Age: 13.0
Sex: F
Vaccine: HPV4, VARCEL
Symptoms: Injection site erythema, Injection site induration, Injection site pain
Clinical narrative: 24 hours after vaccine, patient had a central locally tender, red, slightly indurated area at varivax immunization site.
Age: 34.0
Sex: F
Vaccine: MMR
Symptoms: Arthralgia, Pain
Clinical narrative: Patient was given MMR vaccine on 1/18/08.  Started with body aches on 1/22/08.  Joint aches/Arthralgias on 1/23/08.
Sex: F
Vaccine: UNK
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Medication error
Clinical narrative: Accidental Sub Q injection of MENcn-ACYW vaccine; 4 x 3 cm Red tender indurated Area at site of Sub Q injection left ventral forearm; Advised ice, NSAIDS prn.
Age: 1.5
Sex: M
Vaccine: FLU3
Symptoms: Febrile convulsion
Clinical narrative: Febrile seizure in 24 hours of receiving vaccine.  History of previous febrile seizure times 1.  Child also with bronchial symptoms (like sib).
Age: 2.0
Sex: M
Vaccine: FLU3
Symptoms: Haematuria, Henoch-Schonlein purpura, Nephritis, Petechiae, Purpura
Clinical narrative: HSP - dev. vomiting, viral exanthem on 1/4/08, received vaccine 1/9/08, dev. purpural petechiae subsequently - diagnosed with HSP 1/9/08; Also dev. Nephritis, including gross hematuria 1/14/08. Rx with steroids
Age: 2.0
Sex: M
Vaccine: FLU3
Symptoms: Urine analysis, Viral rash, Vomiting
Clinical narrative: HSP - dev. vomiting, viral exanthem on 1/4/08, received vaccine 1/9/08, dev. purpural petechiae subsequently - diagnosed with HSP 1/9/08; Also dev. Nephritis, including gross hematuria 1/14/08. Rx with steroids
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Blepharospasm
Clinical narrative: Soon after receiving vaccine on 1/30/08, child began blinking his eyes uncontrollably - seen by PMD, given Benadryl on 1/31 - much improved 2/01.
Age: 4.0
Sex: F
Vaccine: IPV, MMR, TDAP, VARCEL
Symptoms: Inappropriate schedule of drug administration, Medication error, Wrong drug administered
Clinical narrative: Dose of TDAP (Adacel) given instead of DTAP (Daptacel).
Age: 1.0
Sex: F
Vaccine: HIBV, MMR, PNC, VARCEL
Symptoms: Rash
Clinical narrative: MMR given 1-14-08.  Came to see provider 1-29-08.  Has rash on chest area, face and neck.  Started 1-27-08. Doctor diagnosed with reaction to MMR.  Treated with "Benadryl".
Age: 12.0
Sex: M
Vaccine: DTAP, HEPA, MNQ
Symptoms: Pain in extremity, Pyrexia, Skin reaction
Clinical narrative: fevers 102, arm pain, adverse skin reaction both arms
Age: 16.0
Sex: F
Vaccine: HPV4
Symptoms: Dizziness
Clinical narrative: Dizziness, light headed, prolonged observed in office. Rx Meclizine. Mom claims similar symptoms lasted 1 wk after the 1st Gardasil dose.
Age: 0.2
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Constipation, Stool analysis normal
Clinical narrative: Mother described normal nursing baby with normal bowel movements.  After 2 months vaccines was constipated for 2 days and continued to 4 month shots.  Appointments with 3 different doctors all advising BM's would return to normal but still dealing with constipation. Use apple/prune juice for constipation.
Age: 89.0
Sex: M
Vaccine: VARZOS
Symptoms: Angioedema, Drug hypersensitivity, Rash, Urticaria
Clinical narrative: Progressive Rash/Hives onset about 48 hours progressing still at 72 hours; Angioedema of upper lip
Age: 1.6
Sex: M
Vaccine: HEPA, MMR
Symptoms: Pyrexia
Clinical narrative: Temperature 104.0 ax 10 days after receiving MMR/Hep A vaccines.  Fever lasted a few days.  Parent reported this information to after hours care-pediatric acute care 9/8/07.
Age: 1.1
Sex: M
Vaccine: HBHEPB, IPV
Symptoms: Rash, Varicella
Clinical narrative: Broke out with varicella rash 1/26/08.
Age: 1.0
Sex: M
Vaccine: FLU3, HEPA, MMR, PNC, VARCEL
Symptoms: Abdominal X-ray, Blood culture, Chest X-ray, Culture urine, Cyanosis
Clinical narrative: Fever 104 degrees, pallor, perioral cyanosis & trembling.  Emesis x1.  Rapid onset within 24 H of vaccinations.  Transported to local ED where septic W/U was negative.  No other signs/symptoms of disease.  Fully recovered within 48 H.
Age: 1.0
Sex: M
Vaccine: FLU3, HEPA, MMR, PNC, VARCEL
Symptoms: Full blood count, Metabolic function test, Pallor, Pyrexia, Tremor
Clinical narrative: Fever 104 degrees, pallor, perioral cyanosis & trembling.  Emesis x1.  Rapid onset within 24 H of vaccinations.  Transported to local ED where septic W/U was negative.  No other signs/symptoms of disease.  Fully recovered within 48 H.
Age: 1.0
Sex: M
Vaccine: FLU3, HEPA, MMR, PNC, VARCEL
Symptoms: Urine analysis, Vomiting
Clinical narrative: Fever 104 degrees, pallor, perioral cyanosis & trembling.  Emesis x1.  Rapid onset within 24 H of vaccinations.  Transported to local ED where septic W/U was negative.  No other signs/symptoms of disease.  Fully recovered within 48 H.
Age: 17.0
Sex: F
Vaccine: HPV4, MNQ
Symptoms: Injection site pain, Insomnia, Musculoskeletal stiffness, Nausea, Pallor
Clinical narrative: Started to complain of pain in right deltoid -site of injection; HPV #2, 2 hrs after injection - felt stiff - difficulty sleeping ; Next a.m. very pale dizzy, nausea. went to ER that night 1/14
Age: 1.1
Sex: M
Vaccine: MMR
Symptoms: Expired drug administered
Clinical narrative: MMR given to child; while documenting vaccine noticed expiration date of 4-6-07, checked all doses in box as well as exp. date on box, lot # was 0150F; exp 4/09.  Need to repeat MMR after 28 days.
Age: 13.0
Sex: F
Vaccine: HPV4
Symptoms: Asthenia, Breath holding, Muscle spasms, Pallor, Unresponsive to stimuli
Clinical narrative: Patient was in for her second HPV shot and was given it without any difficulty at approximatly 03:55 pm on 01-30-2008.  They had left the health department and got in private vehicle.  Mother came running back in and stated that patient had spazed or something.  The mother said she had jerked and moved her arms around and was scaring her.  I went out to the vehicle and patient was sitting in an upright position and was very pale she was alert and oriented x3.  She said she couldn't hear her mother talking to her and mother said she couldn't respond.  Her mother had asked her if she was joking or what and patient told her no.  I brought her back into the health department obtained her vital signs and they were stable  (B/P 118|74 heart rate 58, respirations 16). Patient stated that she felt very weak. This was approximately 04:05 pm I layed her down and elevated her feet.  She remaind alert and oriented.  Her color came back to her face and I released her to her mothers care with instructions to take her to emergency room if any other problems and to let us know at 04:30pm.  I called to follow up with her at approximately 05:30pm and patient had had no other problems. Patient was very nervous about the shot but was in the room with her little brother so she tried to be very big about it.  She had started laughing and then held her breath for just a second while I was giving the shot.  She had watched her little brother take his shots and he was a fighter.
Age: 1.19
Sex: M
Vaccine: HIBV, MMR, PNC, VARCEL
Symptoms: Abnormal behaviour, Autism, Hypersomnia, Laziness
Clinical narrative: Patient experienced lazy behaviors after the vaccines.  He slept all day and all night.  When he awoke he was a different child.  He was not making sounds or smiling anymore.  He was diagnosed as autistic on Jan 3 2007.    2/5/08 Reviewed vax record & database corrected. 2/21/08 Reviewed developmental pediatrician notes of 1/3/2007 which reveal patient experienced clumsiness, frequent falls, rocking, hand slapping, hand wringing, starring, poor eye contact, poor social & play skills, unusual noises but very little speech (uses simple signs) , grossly hypotonic, severely bilaterally internally rotated feet, poor balance, delayed gross motor skills, poor protective skills.  Referred to behavioral specialist, nutritionist, parent trainer, OT/PT/ST. FINAL DX: Autism spectrum disorder.
Age: 4.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MUR
Symptoms: Injection site induration, Injection site pain
Clinical narrative: Induration and redness with mild tenderness around injection site 12 cm in diameter in 24 hrs after shot. Patient was asked to follow up. Never did.
Age: 6.0
Sex: F
Vaccine: VARCEL
Symptoms: Erythema, Mass, Pruritus, Rash
Clinical narrative: L LEG IS RED AND ITCHY WITH KNOT AND RASH.
Age: 37.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site induration, Injection site nodule, Injection site pain, Injection site pruritus
Clinical narrative: DAP injection given on the right arm approx given on January 2nd. The area became swollen, red and hard. Approx. 2 weeks later, the area was still swollen, red and began to itch. The itching lasted approx. 7 days. It is now 2/4/08 and there is still a pea-sized knot there which tends to be painful if touched.
Age: 37.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site swelling
Clinical narrative: DAP injection given on the right arm approx given on January 2nd. The area became swollen, red and hard. Approx. 2 weeks later, the area was still swollen, red and began to itch. The itching lasted approx. 7 days. It is now 2/4/08 and there is still a pea-sized knot there which tends to be painful if touched.
Age: 5.0
Sex: M
Vaccine: HIBV
Symptoms: Asthenia, Cough, Dyspnoea, Eye swelling, Pyrexia
Clinical narrative: High fever started from the date of immunization lasting already 5 days (still have as of this time) from 38C to 40C, weakness, sleepiness, swollen eyes, some shortness of breath and coughing. (The manufacturer of vaccine is Aventis, as recorded in medical history by nurse/doctor, lot number is not clear).
Age: 5.0
Sex: M
Vaccine: HIBV
Symptoms: Somnolence
Clinical narrative: High fever started from the date of immunization lasting already 5 days (still have as of this time) from 38C to 40C, weakness, sleepiness, swollen eyes, some shortness of breath and coughing. (The manufacturer of vaccine is Aventis, as recorded in medical history by nurse/doctor, lot number is not clear).
Age: 9.0
Sex: F
Vaccine: VARCEL
Symptoms: Erythema, Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia
Clinical narrative: Red, raised warm area on left arm at site of vaccine administration starting several hours after vaccine; fever (Tm 100.4) and left cheek red one day after vaccine.
Age: 50.0
Sex: M
Vaccine: HEP
Symptoms: Arthralgia, Pain in extremity
Clinical narrative: Patient developed pain in lower half of left upper arm and left elbow joint the day after receiving the vaccine.  Now one month later, there is still pain in the left elbow, but it is less than it was before.  No swelling noted in left elbow.
Age: 13.0
Sex: F
Vaccine: FLUN3, HEPA, HPV4, MNQ, TDAP
Symptoms: Blood glucose, Blood pressure, Dizziness, Fatigue, Head injury
Clinical narrative: After receiving immunizations client immediately left clinic with mother and siblings.  She felt light headed and fainted.  This was not witnessed by any staff members.  Mother reported child struck right cheek when she fell.  At home developed nausea/vomiting and became very tired.  Mothe took child to emergency department for evaluation.
Age: 13.0
Sex: F
Vaccine: FLUN3, HEPA, HPV4, MNQ, TDAP
Symptoms: Nausea, Syncope, Vomiting
Clinical narrative: After receiving immunizations client immediately left clinic with mother and siblings.  She felt light headed and fainted.  This was not witnessed by any staff members.  Mother reported child struck right cheek when she fell.  At home developed nausea/vomiting and became very tired.  Mothe took child to emergency department for evaluation.
Age: 33.0
Sex: F
Vaccine: HEP
Symptoms: Muscle disorder, Neck pain, Pain in extremity
Clinical narrative: 1/28/08 patient reported lower arm and hand sore from lifting her child. On 2/1/08 reported that entire arm and up into neck is sore. No c/o redness, warmth, or elevated temp since injection. No c/o discomfort when received injection or tingling in arm. Advised patient to go to her provider or urgent care center for assessment. 2/01/2008 patient reported to her supervisor that she went to Dr. who said that patient may have a muscle tear and is sending her for physical therapy to see if relief obtained. PT started on 2/04/2008.
Age: 45.0
Sex: F
Vaccine: FLU3
Symptoms: Fatigue, Muscle twitching, Musculoskeletal discomfort, Nausea, Nervousness
Clinical narrative: Twitching in left thumb one day following influenza injection.  Parasthesia left foot, progressing to right foot and bilat hands.  Twitching of various body parts.  Banding discomfort and nerve pain in extremities.  Shakiness, nervousness, night sweats, nausea, neck and back discomfort, lip tingling, exhaustion.  Symptoms ongoing since 11/2/2007.  Seeing various doctors/specialties including neuro, ID, Rheum.  02/25/2008 Lengthy neurology and endocrinology consults received dated 1/25/08 and 2/12/2008 respectively with no definative DX provided. Pt reported twitching of the L thumb, tingling of both feet, extreme fatigue, upper back pain, neck pain, shoulder blade pain, LBP, flank pain, calf pain, cramping of the foot, limb heaviness,  weakness, muscle twitching, night sweats and formication.  PE (+) for minimal ankle edema, 3+ DTRs at the patellae otherwise WNL. No Dx made at this time by neuro. Endocrine consult for mildly elevated Cacium levels with no clear Dx.  Plan to follow over time.
Age: 45.0
Sex: F
Vaccine: FLU3
Symptoms: Night sweats, Pain in extremity, Paraesthesia, Paraesthesia oral, Tremor
Clinical narrative: Twitching in left thumb one day following influenza injection.  Parasthesia left foot, progressing to right foot and bilat hands.  Twitching of various body parts.  Banding discomfort and nerve pain in extremities.  Shakiness, nervousness, night sweats, nausea, neck and back discomfort, lip tingling, exhaustion.  Symptoms ongoing since 11/2/2007.  Seeing various doctors/specialties including neuro, ID, Rheum.  02/25/2008 Lengthy neurology and endocrinology consults received dated 1/25/08 and 2/12/2008 respectively with no definative DX provided. Pt reported twitching of the L thumb, tingling of both feet, extreme fatigue, upper back pain, neck pain, shoulder blade pain, LBP, flank pain, calf pain, cramping of the foot, limb heaviness,  weakness, muscle twitching, night sweats and formication.  PE (+) for minimal ankle edema, 3+ DTRs at the patellae otherwise WNL. No Dx made at this time by neuro. Endocrine consult for mildly elevated Cacium levels with no clear Dx.  Plan to follow over time.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Local reaction
Clinical narrative: MARKED LOCAL ERYTHEMA AND TENSE EDEMA W/ TENDERNESS, BUT NO INFECTION NOTED AROUND INJECTION SITE -- MODERATE SEVERITY, LOCAL IMMUNE REACTION 3 DAYS POST-VACCINE.  TREATED W/ NSAIDS AND COOL COMPRESS.
Age: 45.0
Sex: F
Vaccine: FLU3
Symptoms: Alopecia, Burning sensation, Clostridial infection, Clostridium difficile toxin test positive, Erythema
Clinical narrative: Patient and I took shots through a drive through clinic on october 10 2007. Her Left arm puffed up RED after the shot. The area was 3"x 2" Square area. Then It went away. On Oct 26 she was stung on the face by a large mosquito. She became sick after that and has been sick ever since then. She has pain all over her body, her hair is falling out, her hair quit growing on her legs and her underarms. She has horrible burning under her scalp, spreading down her back and spreading from her chest up towards her neck as off this morning. It's red splotchy and burns horribly. She has not been able to sleep since the shot. She stairs at the ceiling at night and has not slept since then even with sleep meds. She catches cat naps during the day maybe 1 or 2 hours. Patient was first put in the hospital for 5 day's before they found out she had C-Diff. The second time she had almost 0% potassium and was hospitalized for another 5 day's in the (PCU) pulmonary care unit. She was very sick but still has the burning and her hair is falling out in clumps. Before all of this happend she was a happy go lucky house wife taking care of me (because I am 100% diabled. She is now 100% disabled due to this illness. Please come up with an answer to the burning and hair loss it's very difficult to watch her in so much pain (Submitted by her husband).  2/14/08 Reviewed medical records which reveal patient experienced rash, burning skin, nausea & diarrhea, low grade fever.  Admitted 11/21-11/28/2007.  GI consult done.  Developed grossly bloody diarrhea.  Also had recent exposure to shingles & family member w/diarrhea, had a recent cat scratch & recent mosquito bite.  Cat scratch & mosquito bite areas were swollen & indurated.   D/C Dx: diarrhea, resolved; gastric erosions/ulcer, H. pylori neg; grade A esophagitis; duodenitis.  Diarrhea & fatigue recurred & re-admitted 12/14-12/17/2007.  Tx w/dual antibiotics & improved.  D/C dx: c.diff colitis. FINAL DX: None provided.
Age: 45.0
Sex: F
Vaccine: FLU3
Symptoms: Laboratory test, Oedema peripheral, Pain, Sleep disorder
Clinical narrative: Patient and I took shots through a drive through clinic on october 10 2007. Her Left arm puffed up RED after the shot. The area was 3"x 2" Square area. Then It went away. On Oct 26 she was stung on the face by a large mosquito. She became sick after that and has been sick ever since then. She has pain all over her body, her hair is falling out, her hair quit growing on her legs and her underarms. She has horrible burning under her scalp, spreading down her back and spreading from her chest up towards her neck as off this morning. It's red splotchy and burns horribly. She has not been able to sleep since the shot. She stairs at the ceiling at night and has not slept since then even with sleep meds. She catches cat naps during the day maybe 1 or 2 hours. Patient was first put in the hospital for 5 day's before they found out she had C-Diff. The second time she had almost 0% potassium and was hospitalized for another 5 day's in the (PCU) pulmonary care unit. She was very sick but still has the burning and her hair is falling out in clumps. Before all of this happend she was a happy go lucky house wife taking care of me (because I am 100% diabled. She is now 100% disabled due to this illness. Please come up with an answer to the burning and hair loss it's very difficult to watch her in so much pain (Submitted by her husband).  2/14/08 Reviewed medical records which reveal patient experienced rash, burning skin, nausea & diarrhea, low grade fever.  Admitted 11/21-11/28/2007.  GI consult done.  Developed grossly bloody diarrhea.  Also had recent exposure to shingles & family member w/diarrhea, had a recent cat scratch & recent mosquito bite.  Cat scratch & mosquito bite areas were swollen & indurated.   D/C Dx: diarrhea, resolved; gastric erosions/ulcer, H. pylori neg; grade A esophagitis; duodenitis.  Diarrhea & fatigue recurred & re-admitted 12/14-12/17/2007.  Tx w/dual antibiotics & improved.  D/C dx: c.diff colitis. FINAL DX: None provided.
Age: 1.03
Sex: M
Vaccine: HIBV, MMR, VARCEL
Symptoms: Rash vesicular
Clinical narrative: Varicella rash.
Age: 0.31
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5, DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Diarrhoea haemorrhagic, Enema administration, Intussusception, Vomiting
Clinical narrative: Patient presented to ER on 2/2/08 with vomiting, bloody diarrhea; had Abdominal U/S which showed intussusception which was followed by a barium enema which showed resolution of intussusception, still in hospital as of today 2/4/2008. 2/22/08-records received for DOS 2/3-2/4/08-Gastroenteritis with hematochezia resolved intussusception. C/O diarrhea 2/2/08, watery stools. Vomiting and blood noted in stool. Fussy.
Age: 0.31
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5, DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Abdominal X-ray, Barium enema, Diarrhoea haemorrhagic, Enema administration, Intussusception
Clinical narrative: Patient presented to ER on 2/2/08 with vomiting, bloody diarrhea; had Abdominal U/S which showed intussusception which was followed by a barium enema which showed resolution of intussusception, still in hospital as of today 2/4/2008. 2/22/08-records received for DOS 2/3-2/4/08-Gastroenteritis with hematochezia resolved intussusception. C/O diarrhea 2/2/08, watery stools. Vomiting and blood noted in stool. Fussy.
Age: 0.31
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5, DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Ultrasound abdomen abnormal
Clinical narrative: Patient presented to ER on 2/2/08 with vomiting, bloody diarrhea; had Abdominal U/S which showed intussusception which was followed by a barium enema which showed resolution of intussusception, still in hospital as of today 2/4/2008. 2/22/08-records received for DOS 2/3-2/4/08-Gastroenteritis with hematochezia resolved intussusception. C/O diarrhea 2/2/08, watery stools. Vomiting and blood noted in stool. Fussy.
Age: 1.04
Sex: M
Vaccine: FLU3, MMR, PNC, VARCEL
Symptoms: Rash generalised
Clinical narrative: RASH ALL OVER BODY STARTED 01-28-2008.
Age: 27.0
Sex: F
Vaccine: FLU3
Symptoms: Eyelid oedema, Rash
Clinical narrative: Eye lids began swelling within 24 hours of vaccine administration.  Next day developed rash on face and neck.  Sought treatment in emergency room.  Treated with Prednisone, Benadryl and Doxycycline per patient report.
Age: 69.0
Sex: M
Vaccine: VARZOS
Symptoms: Dizziness, Paraesthesia
Clinical narrative: Patient was given Zostavax (lot1089U) and immediately felt tingles in arm.  Appr. 30 seconds later patient felt faint and stunned.  I laid patient on ground to prepare for CPR and EMT arrived. Patients wife said he had diabetes and that they had not been checking blood sugar.  EMT said they think his faint spell was due to blood sugar and not vaccine related.  EMT took him to hospital.
Age: 1.55
Sex: M
Vaccine: DTAP
Clinical narrative: Patient had several episodes of limpness 15-18 hours after receiving a DTaP in the physician's office.  04/23/2008 MR received for DOS 1/31-2/1/2008 with D/C DX: Hypotonic-hyporesponsive episode of unknown etiology.  Pt presented to local ER with episode of limpness with unresponsiveness lasting about 1 min one day s/p vax.  Pt had another episode in ER lasting ~30 sec. Neuro consult with normal exam.  No further episodes.
Age: 7.0
Sex: F
Vaccine: VARCEL
Symptoms: Blister
Clinical narrative: CLUSTER OF BLISTERS, NON TENDER, NON ERYTHEMATOUS, NON CELLULITIS FROM RUE.
Age: 30.0
Sex: F
Vaccine: PPV, TDAP
Symptoms: Blood glucose increased, Feeling drunk, Migraine, Syncope
Clinical narrative: Faint, wooly cottony head. Client reports that she feels "drunk". Client was taken to MD who diagnosed her conditon to be: Migraine. Dr. gave the client Rx and advised her to go home.
Age: 32.0
Sex: F
Vaccine: MMR
Symptoms: Arthralgia, Pain in extremity
Clinical narrative: PT RECEIVED MMR VACCINATION IN LEFT ARM ON 1/15/2008. STATED THAT ABOUT 1 WEEK POST VACCINATION, PT.'S LEFT HAND WAS FEELING SORE WITH A DULL, ACHY PAIN. THE NEXT DAY, SHE BEGAN TO FEEL THE SAME PAIN IN HER RIGHT HAND IN THE "MIDDLE JOINTS" OF HER HANDS. PT. ALSO REPORTED THAT AT ONE POINT HER KNEES WERE ACHING. RECOMMENDATION FOR PT. TO MAKE AN OFFICE VISIT TO SEE PMD.
Age: 60.0
Sex: M
Vaccine: FLU3
Symptoms: Arthralgia, Chest X-ray, Computerised tomogram, Injection site pain, Musculoskeletal pain
Clinical narrative: At 10:30 AM had a flu vaccine on 10/26/07.  On 11/01/07 came to ER 10:16 AM with c/o persistent pain from site to wrist in L arm.  Doesn't radiate to thumb & little finger, c/o nausea with pain.  Pain 10/10 sharp.  Has also trapezius pain intermittently.  Came in with EP, had full workup.  Dilaudid x2, CT of chest, CXR.
Age: 60.0
Sex: M
Vaccine: FLU3
Symptoms: Nausea, Pain, Pain in extremity
Clinical narrative: At 10:30 AM had a flu vaccine on 10/26/07.  On 11/01/07 came to ER 10:16 AM with c/o persistent pain from site to wrist in L arm.  Doesn't radiate to thumb & little finger, c/o nausea with pain.  Pain 10/10 sharp.  Has also trapezius pain intermittently.  Came in with EP, had full workup.  Dilaudid x2, CT of chest, CXR.
Age: 26.0
Sex: F
Vaccine: HPV4
Symptoms: Abdominal pain, Back pain
Clinical narrative: Pecived 2ND gardasil tue. jan 29th. Started having abd. pain that Night. Pain Sharp and Radiated into Back. Patient called 2-1-08 at 430 pm to Ask if related to shot. No Nausea; No vomiting. No Fever. Pain gone by Am 2-2-08. was instructed to go to ER if symptoms got worse.
Age: 17.0
Sex: F
Vaccine: HPV4
Symptoms: Injection site nodule, Injection site pain
Clinical narrative: Pt received HPV #2 on 1/14/08.  Since has had pain at site + small tender nodule in muscle at site.  No redness or s/s infection.
Age: 51.0
Sex: M
Vaccine: TDAP
Symptoms: Hypoaesthesia, Injection site anaesthesia
Clinical narrative: After 10 minutes from receiving a Tdap in my left arm.  My left arm and hand went numb.  Received Tdap at 12:10 pm on 2/1/2008.  Course of treatment recommendations: Call MD asap for advice.  Rest and elevate left arm. Ice and warm packs at 20 minute intervals alternating ice and warm every two hours.  Tylenol over the counter for comfort.  Client denies any chest pain, no shortness of breath noted at time of interview.  Let Medical MD know of recommendations and stop treatment if MD indicates to.  2/4/2008-Left message for patient to call.  Returned call 10 minutes later.  Stated that arm was numb until 8:30 pm on 2/1/2008.  Arm gradually recovered over time.  Did not do recommended treatment.  Stated arm is better now.
Age: 11.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Anxiety disorder, Expired drug administered, No adverse reaction
Clinical narrative: Menactra was given on 1/31/08. Expiration of vaccine was 1/19/08; no adverse reaction
Age: 10.0
Sex: M
Vaccine: HEPA
Symptoms: Incorrect dose administered, No adverse reaction
Clinical narrative: Hepatitis A (Havrix) adult dose given instead of child dose.  f/u with patient no adverse reaction.
Age: 26.0
Sex: F
Vaccine: VARCEL
Symptoms: Pruritus, Rash
Clinical narrative: Rash bilateral arms & face, c/o itching.
Age: 47.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Oedema peripheral, Skin warm
Clinical narrative: Red, swollen - left arm - warm to touch; was instructed to take Clarinex or Benadryl 1% Hydrocortisone cream to skin - ice; notify if any worse - 2/4/08- No follow up complaint from patient.
Age: 24.0
Sex: M
Vaccine: ANTH
Symptoms: Arthralgia, Asthenia, Fatigue, Myalgia
Clinical narrative: Description: Developed joint and muscle pain x3 weeks after 1st AVA.  Needed high dose NSAIDS round the clock to maintain function.  Sxs abated after 3 weeks.  One month after vaccine receipt developed a fatigue  state that has continued to be present.  Lacks the stamina he had before receiving the shots and needs more frequent rest periods.  Symptom: Joint Pain, multiple joints.  Symptom: Muscle Pain.  Symptom: Fatigue, malaise >60 Days.  Has recovered from myalgias/arthralgias.  Has not recovered from fatigue.
Age: 57.0
Sex: F
Vaccine: VARCEL
Symptoms: Blister, Rash generalised
Clinical narrative: Patient received varicella vaccine (1st dose ever) 10-22-07. Had 1st outbreak of rash with blisters 0024, crusted over on 10-29-07. No fever, No pain. lasted 1 wk. Had 2nd out break 12-25-07; rash more extensive (over trunk, arms, legs); raised vesicles no fever, more itching, bigger blisters. Diagnosed by own MD
Age: 1.3
Sex: F
Vaccine: UNK
Symptoms: Oedema peripheral
Clinical narrative: Swelling of entire right leg (where immunization given)
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Varicella
Clinical narrative: Varicella disease >20 lesions
Age: 4.0
Sex: F
Vaccine: DTAP
Symptoms: Abdominal pain, Injection site erythema, Injection site induration, Injection site warmth, Pyrexia
Clinical narrative: Fever 101 deg on 01-09-08 24 hr. after immunization was given. On 01-10-08 AM - child developed abdominal pain and vomiting x1. Injection site was erythematous, warm and hard. Doctor diagnosed mild to moderate reaction. No fever on 1-10-08; Treatment: Ice and Tylenol
Age: 4.0
Sex: F
Vaccine: DTAP
Symptoms: Vomiting
Clinical narrative: Fever 101 deg on 01-09-08 24 hr. after immunization was given. On 01-10-08 AM - child developed abdominal pain and vomiting x1. Injection site was erythematous, warm and hard. Doctor diagnosed mild to moderate reaction. No fever on 1-10-08; Treatment: Ice and Tylenol
Sex: U
Vaccine: HEP
Symptoms: Unevaluable event
Clinical narrative: This is not an incident report, it is a look-alike packing report (sorry if this is the wrong place). The Hepatitis B Vaccines manufactured by GlaxoSmithKline recently underwent a labeling change. The adult and pediatric vaccines look very similar, and previously the pediatric formulation said "Pediatric/Adolescent" formation on the syringe (this is the mechanism our pharmacists and NICU nurses used to verify they were using the right vaccine). Glaxo has changed the labeling and pediatric formulation no longer states this on the package. The two syringes are different colors, but suddenly our usual safeguard against accidentally switching these syringes is gone and we would like it back.
Age: 1.5
Sex: F
Vaccine: DTAP, FLU3, MMR, DTAP, FLU3, MMR, VARCEL
Symptoms: Culture wound positive, Incisional drainage, Injection site pain, Injection site reaction, Skin lesion
Clinical narrative: Pt with abscess L thigh s/p injection 12/18/07-Pasteur L2606AA Exp 3/15/09.  Culture grew E. agglomerans.  I&D done 1/22/08.
Age: 1.5
Sex: F
Vaccine: DTAP, FLU3, MMR, DTAP, FLU3, MMR, VARCEL
Symptoms: Culture positive, Enterobacter infection, Injection site abscess
Clinical narrative: Pt with abscess L thigh s/p injection 12/18/07-Pasteur L2606AA Exp 3/15/09.  Culture grew E. agglomerans.  I&D done 1/22/08.
Age: 31.0
Sex: F
Vaccine: DTAP
Symptoms: Mobility decreased, Pain in extremity
Clinical narrative: Severe pain in upper arm lasting more than 1 week and limited mobility in arm after receiving TDAP shot.
Age: 19.0
Sex: F
Vaccine: HEPA, SMALL
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site swelling, Pain in extremity
Clinical narrative: Pt received smallpox vaccination on 18 Jan 08. First seen at ER on 27 Jan 08 then again on 29 Jan.  Reported LUE pain and sweeling for days s/p small pox vaccination.  Initially had pruritic, erythematous, sparse rash but widely distributed acoss trunks and extremities with more concentrated at (L) deltoid. On 29 Jan with increased redness, pain and swelling for several days at vacc site. No fevers.  Pt reported FHx of Eczema.   P/E SKIN LUE: Necrotic plaque x 1 Cm diameter w/ surrounding erythema, heat , TTP and swelling approx 8 x 10 Cm, marked with purple pen. Also larger distrubution of slightly raised erythematous lesions, 1 Cm across trunk and concentrated around cellulitis of LUE. Pt reported additional identical lesions on her legs.  TREATMENT: On 27 Jan: Oral Benadryl 25mg and Prednisone 60mg in ER, then discharged on HC 1% Crm AAA BID prn.  On 29 Jan: Keflex 500mg po QID #40, Motrin 400mg QID PRN.
Age: 19.0
Sex: F
Vaccine: HEPA, SMALL
Symptoms: Pregnancy test, Rash erythematous, Rash pruritic, Skin lesion, Skin necrosis
Clinical narrative: Pt received smallpox vaccination on 18 Jan 08. First seen at ER on 27 Jan 08 then again on 29 Jan.  Reported LUE pain and sweeling for days s/p small pox vaccination.  Initially had pruritic, erythematous, sparse rash but widely distributed acoss trunks and extremities with more concentrated at (L) deltoid. On 29 Jan with increased redness, pain and swelling for several days at vacc site. No fevers.  Pt reported FHx of Eczema.   P/E SKIN LUE: Necrotic plaque x 1 Cm diameter w/ surrounding erythema, heat , TTP and swelling approx 8 x 10 Cm, marked with purple pen. Also larger distrubution of slightly raised erythematous lesions, 1 Cm across trunk and concentrated around cellulitis of LUE. Pt reported additional identical lesions on her legs.  TREATMENT: On 27 Jan: Oral Benadryl 25mg and Prednisone 60mg in ER, then discharged on HC 1% Crm AAA BID prn.  On 29 Jan: Keflex 500mg po QID #40, Motrin 400mg QID PRN.
Age: 19.0
Sex: F
Vaccine: HEPA, SMALL
Symptoms: Swelling, Urine analysis
Clinical narrative: Pt received smallpox vaccination on 18 Jan 08. First seen at ER on 27 Jan 08 then again on 29 Jan.  Reported LUE pain and sweeling for days s/p small pox vaccination.  Initially had pruritic, erythematous, sparse rash but widely distributed acoss trunks and extremities with more concentrated at (L) deltoid. On 29 Jan with increased redness, pain and swelling for several days at vacc site. No fevers.  Pt reported FHx of Eczema.   P/E SKIN LUE: Necrotic plaque x 1 Cm diameter w/ surrounding erythema, heat , TTP and swelling approx 8 x 10 Cm, marked with purple pen. Also larger distrubution of slightly raised erythematous lesions, 1 Cm across trunk and concentrated around cellulitis of LUE. Pt reported additional identical lesions on her legs.  TREATMENT: On 27 Jan: Oral Benadryl 25mg and Prednisone 60mg in ER, then discharged on HC 1% Crm AAA BID prn.  On 29 Jan: Keflex 500mg po QID #40, Motrin 400mg QID PRN.