Age: 29.0
Sex: F
Vaccine: FLU3
Symptoms: Nasal congestion, Oral herpes, Paraesthesia oral, Speech disorder, Swelling face
Clinical narrative: *may or may not be relevant to flu vaccine.:within 1 week of vaccine-severe headaches, nasal congestion, tired, within 4th week after vaccine:pain behind right ear, cold sore on outside left lower lip, 10/25/07-sudden numbness to left cheek, rt of mouth dropped causing drooling, no blinking from rt eye, rt side of face flattened, lt side of face swelled, visited er for fear of stroke, Dr diagnosed with Bells' Palsey after CAT Scan cleared, then requested to keep lubricating eye with lacri-lube at night, and prescribed steroids, and and antiviral medication with referral to nose ear throat speacialist, 10/26/07-front top of tongue tingly and numb, some foods taste different, trouble eating and drinking from a cup, need assistance drinking by using straw and holding lips closed aroung straw, MD appointment with ENT Specialist- gave me same advice as Dr, and lenghtened medicatin use for up to 2 weeks; also had audioaulogy testing for any loss of hearing, 10/27/07-words with b,f, or p are difficult to pronounce, vision now blurred to rt eye, must wear patch and keep lubricationg with artificial tears, worked this day causing emotinal distress because of peoples reactions to my face, symptoms have progressively gotten worse and more difficult, 10/28/07- rt nostril has drooped causing less airway, and more dificulty breathing when eating or drinking, 10/29/07-saw family physician for third opinion, and said to expect it to get worse, but the Bell's Palsey will reach it's peak depending on the person, then improve very slowly, may take a couple of weeks to several months at least, prescribed anitbiotic and pain med for uti and pain for headaches and right ear cramps, hearing to rt ear is extra sensitive to loud noises, or lound bong sounds (feels like a thick needle piercing throught my right ear causing so much pain my body trembles and i cry (:<)). 12/1/07- no change lots of ear pain and blurred vision on rt side. Advise Bell's Palsey is still an unknown disorder (not knowing the culprit that causes this, but have linked to possibly be cause by a virus)  12/4/07 Reviewed vax record from HD which provided Sanofi Lot# U2452A & corrected date of vax to 10/26/2007.  12/4/07 Reviewed ER medical records of 11/25/2007 which reveal patient experienced sudden onset right facial droop, left side numbness & HA x 1 day.  Tx w/antivirals & steroids. FINAL ER DX: Bell's Palsy. 12/7/07 Reviewed pcp medical record of 11/29/07 which reveal patient experienced facial numbness & HA since 11/25/07.  Also c/o dysuria.  Given additional antiviral & eye ointment & patch.  Already scheduled to see ENT.  FINAL DX: Bell's palsy, dysuria, UTI. 1/22/08 Reviewed ENT medical records which reveal patient initially seen 11/26/07. Dx right Bell's palsy.  Tx w/steroids/antiviral & eye protection. Returned 2/18/07 & experienced extreme sound sensitivity & gen discomfort worsening.  Facial weakness remained.  Returned 2/28/07 s/p MRI which revealed maxillary sinusitis.  Tx w/antibiotic.  Bell's palsy improved. FINAL DX: right Bell's palsy but w/increased right ear pain & sound sensitivity; maxillary sinusitis.