Age: 0.17
Sex: M
Vaccine: DTAPHEPBIP, DTPHIB
Symptoms: Cyanosis, Dyspnoea, Eye disorder, Hypotonia, Panic reaction
Clinical narrative: See attached (2 pages). Pt into Dr's office 2/15/06. Between 4-4:30 PM mom changed diaper and patient had an episode-couldn't breathe, turned blue, saliva was coming from mouth, stared at mom.  Mom called 911-baby was okay when they arrived so they didn't transport anywhere. Mom reported eyes were glossy the rest of the evening. No shakes or tremors. 2-16-06 2:30pm call to Dr office spoke with nurse. She states that child was seen on 2-15-06 for an exam and was WNL. They had questioned mom whether child had gone to the bathroom during this incident and she was not sure. The nurse states there was a "little temp" as they were ruling out febrile seizure. Child is known as a "happy spitter", which she explains as a child who "spits up, but is gaining weight." Physician wrote that child had an "immunization reaction", I questioned whether it was stated as "possible", and she state not. I related that this was not a "typical reaction". 2-16-06 2:40pm VAERS form copied and reviewed. Message left at patients home asking mom to call to follow up on Matthew's episode. 2-17-06 Call to patients home not available. Mom returned call later this date. She is calm and sensible in relating what happened. She stated that she laid son down for a diaper change and his "stomach made funny noises" unlike any she had heard before. She stated this is what first caught her attention. She looked at him to see a facial expression of panic that seemed to worsen. She states that he started gasping and turning blue. She turned him over and pounded on his back without changes. After that, she tried to open his mouth, but states that he "wouldn't open mouth". She is unsure if he was clenching and didn't notice tremors or shaking. She continued to "pound on his back" and called 911. She is surprised that they didn't stay on the line. Babe was on corner of bed where she had lain him to call 911 where his behavior changed to "calm, starred and cried". She states that he was breathing when she picked him up and isn't sure if he stopped breathing anytime throughout the episode. He remained "starring and limp" afterward. Mother states that he "didn't burp or throw anything up" during this time. We discussed possible regurgitation and choking as mother states she doesn't know if it was from spitting up or immunization. She was even considering a reaction to the Tylenol, but repeated the dose while she was going to be with him rather then the sitter to see if he had any reaction. She stayed home with him on Tuesday and he was "much better" with normal behavior. He has been fine since. He had a fever that night and at the time of the episode, but Tylenol had been given; Mother unsure of degree. She stated that she is not certain if squad crew took his temperature as she was busy intermittently while they were there, but relates that they (squad crew) did say he had a fever. Later that night, it was 99 degrees and 100 degrees. She continued the Tylenol until 1pm on 2-14-06. Mom has returned to work and continues to breastfeed patient. She seems to be a rational conscientious mom. I commended her for her actions during this event. Nurse obtained the information needed for the VAERS form.