Age: 23.0
Sex: F
Vaccine: ANTH, SMALL
Symptoms: Dyspnoea, Ear pain, Erythema, Fatigue, Febrile neutropenia
Clinical narrative: This 33 year old female received her first AVA (FAV067) on 1/14/2003 and primary SPV (lot # 4020771) on 2/03/2003. Records document complaints of headache, muscle aches, feeling lousy, with swollen axillary lymph nodes and a 7x7 mm vesicle with slight erythema that scabbed ("major take" 2/16/2003) after her SPV. She also advised having a dental cavity filled <30 days prior to vaccinations.On 3/22/2003 (day 49) she reported to medical for 3 days complaint of left>right ear pain with yellowish drainage from her left ear, a sore throat, her "whole body hurts", photosensitivity, watery eyes, tired, headache and sense of being off balance. She had some nausea and vomiting 2 days ago. She was diagnosed with pre-otitis media and given MOTRIN and CEPROCOL throat lozenger. On 4/6/2003 (day 63) she complained of fever and flu like symptoms x 3 days being cold, had pressure in back and around eyes, back of neck unrelieved with EXCEDRIN or MOTRIN. She was diagnosed with acute sinusitis and dehydration and treated with SEPTRA DS, AFRIN nasal spray, SUDAPHED and TYLENOL with IVF's. Symptoms resolved and on 4/30/2003 she was evaluated for stress (death of 2 friends) reporting poor appetite x 1 month. On 5/7/2003 she presented to medical with diarrhea and vomiting x 24 hours, fever, hot/cold chills, night sweats, with positive tilt test and diagnosed with gastroenteritis (no lab/diagnostics studies). On5/10/2003 she was re-evaluated for resolving viral gastroenteritis (VGE). On 5/25/2003 she complained of heat exhaustion while on pier watch with temperature of 104.1 (no longer sweating and outside air temp 100+ degrees), skin flushed hot and dry, fatigue, a non-productive cough x 1 week, nasal congestion, and a sore throat. She also complained of increasing dry non-productive cough with chest comfort with difficulty breathing in secondary to coughing. She described this chest discomfort "as if someone was sitting on my chest" with radiating abdominal and flank pain. CXR's showed hilar lymphadenopathy and enlarged mediastinum with diagnoses of mediastinal lymphadenopathy, pyelonephritis, mild anemia and elevated LFT's. She was medevac's on 5/30/2003. After several difficult biopsies her second VATS procedure (June 2003) confirmed the diagnosis of malignant lymphoma, diffuse large B-cell type with extensive necrosis and multifocal severe lymphoid infiltration or non-Hodgkin's lymphoma. On 6/28/2003 she received AVA #2 (FAV067). On 7/1/2003 she was admitted Stage II-A diffuse large cell lymphoma for chemotherapy via EPOCH-R protocol. In October 2003 and May 2004 repetitive PET scans showed remission and marked reduction of mediastinum tumor mass. Meanwhile, AVA #3 (FAV067) was given on 2/10/2004 with no reported adverse event or reflare of symptoms reported. In April 2005 she was found for work; however in October 2005 a PET/CT scan revealed new activity with biopsies showing Hodgkin's lymphoma (HL). She underwent further chemotherapy in 2005 requiring PROCRIT due to chemo induced anemia, a stem cell transplant in 2006 and was deemed to be in full remission by 2007 where she remains today (2013).