Age: 46.0
Sex: F
Vaccine: PPV
Symptoms: Nuclear magnetic resonance imaging abnormal, Osteoarthritis, Pain, Pain in extremity, Rash
Clinical narrative: On December 8th of 2008, I received a Fluarix, seasonal flu vaccination. One week later I was not feeling well with an overall feeling of sickness and fatigue. By Dec. 20th, 2008 there was burning in my neck, upper thoracic and shoulders, with numbness across both shoulders and pain in my forearms. I also felt weak, tired and my legs felt like they could buckle. The burning in my shoulders and neck started at this time along with severe pain in my forearms, especially with movement of my shoulders. It was very hard to put on my seatbelt, coat, flush toilet, blow dry hair, makeup and my bra and shirt irritated my shoulders, reaching into my back pockets produced even more pain. My arms and shoulders felt heaviness, my forearms ached constantly and any movement of my shoulders produced even more pain. It felt like someone had hit me in the upper back with a baseball bat and control of my arms had diminished. Each day I felt progressively worse. There was also broken capillaries in the front of both shoulders about the size of a quarter. I went to Hospital on January 13th, 2009 with profuse vomiting and pain in my right flank. No cause was found and I was given an IV push to stop the vomiting and for the pain was given pain medication. There was protein in my urine and my white blood cell count was off. With the burning pain comes skin temperature change where the burning is, that has been witnessed by others. In April of 2009 I developed an itchy hive rash over entire body, excluding face. This lasted for several weeks. When the rash cleared over entire body, I noticed a chest rash that remained, with time crept up my neck. This rash is still present and has a line of demarcation half way up my neck. The neck and chest rash has the appearance of sunburn. My hands had deformed into the "waiter tip" position, contracture. I had profound weakness in both arms with both arms shrinking due to muscle loss. I started having severe migraines, with intense burning in the c-spine, shoulders with vomiting. The diagnostic codes my Physicians have used are:  723.4 Brachial neuritis or radiculitis nos 847.0  Neck sprain 722.0  Displacement of cervical intervertebral disc  724.4  Thoracic or lumbosacral neuritis or radiculitis 726.1   Rotator cuff syndrome of shoulder  715.11  Osteoarthrosis localized primary involving shoulder region 726.9    enthesopathy 722.52   Degeneration of lumbar or lumbosacral intervertebral disc  Treatment to date has included EMGS prior to vaccine and after. EMG prior to vaccine on upper extremity is normal. EMG post vaccine on upper extremity shows abnormal/ suggestive Myopathic process. EMG post vaccine lower extremity shows abnormal/ suggestive Myopathic process. I am now being referred elsewhere; appt is been made for August 2010, for 2nd opinion on 723.4 Brachial Neuritis or radiculitis nos and repeat EMG's. There is appointment for on Physiatrist, rehabilitation specialist on July 2010. There has been a forearm muscle biopsy on 4/13/10. Preliminary results were negative and waiting on Electron Microscope Examination results. I have been seen by Orthopedic surgeon for impingement right rotator cuff since October 8th, 2009, with steroid injections. There has been referral also for MRI's, Rheumatologist, Neurologist and physical therapy. I have been unable to work since February 2009 and have been progressively worse. I have trouble sleeping and staying asleep. Prescriptions now include Setraline specific for burning nerve pain and sleep, also Flexiral for muscle spasms.  Muscle weakness and pain in shoulders and arms is profound. I have a loss of motor control also. This has been progressive in destruction to muscle.