Age: 65.0
Sex: M
Vaccine: HEPA
Symptoms: Dehydration, Diarrhoea, Dry mouth, Injection site bruising, Injection site pain
Clinical narrative: This case was reported by a consumer (subject) and described the occurrence of constipation in a 65-year-old male subject who was vaccinated with hepatitis A (manufacturer unspecified) and VIVOTIF (non-gsk). A physician or other health care professional has not verified this report. The subject's medical history included colorectal cancer. The subject was a colorectal cancer survivor since April 2009 and stated that "his GI [gastrointestinal ] system has been fragile since then but he was having regular bowel movements." Concurrent medical conditions included diabetes and high blood pressure. Concurrent medications included insulin (injections), hydrochlorothiazide, Blood pressure medication (Unknown blood pressure medication) and AMITIZA. On 16 August 2013 at 18:15 the subject received 1st dose of hepatitis A (injection, left arm). On 17th, 19th, 21st, and 23rd August 2013, the subject received 1st, 2nd, 3rd, and 4th doses of VIVOTIF (non-GSK). On 17 August 2013, at 3:00, 9 hours after vaccination with hepatitis A, the subject experienced injection site soreness. The subject reported that he "woke up in the middle of night" "with a very sore left arm and thought he might have to go to the hospital emergency room." The subject reported that the "pain subsided so he did not got to the emergency room." On 20 August 2013, 4 days after vaccination with hepatitis A, the subject experienced constipation. On 24 August 2013, the subject sought medical attention at the emergency room because he "had not had a bowel movement in 4 days." The subject reported that "he was told he had a severe reaction to the vaccination." In August 2013, less than a month after vaccination with hepatitis A vaccination, the subject experienced bruise at injection site and arm swelled at injection site. The emergency room physicians noted that he still had bruise injection site, arm swelled at injection site (described as "entire area was still swollen"). On 24 August 2013, the subject was "diagnosed as severely dehydrated." In August 2013, the subject experienced excessive night thirst and wakes up with dry mouth. The subject reported that he was "still waking up every night with raging thirst and a dry mouth which he has never experienced before." The subject was advised to take magnesium citrate, castor oil, and lactulose per the emergency room physician. On 26 August 2013, the subject sought medical attention from his oncologist who "called the event obstipation rather than constipation." On 26 August 2013, the subject was "admitted to the hospital and treated with daily preparations for a colonoscopy of MIRALAX, bisacodyl, and COLACE." The subject received 2 treatments of MIRALAX, bisacodyl and COLACE on 27 August 2013 which "still did not clear his system." The subject received bloodwork, 2 CT(computerised tomogram) scans, and 3 abdominal x-rays which "showed stool stuck in transverse colon." The subject was discharged on 27 August 2013 and advised to take "treatments of AMITIZA, MIRALAX, bisacodyl and COLACE three times a day." The subject is also "periodically using magnesium citrate, castor oil, and lactulose which was prescribed by the emergency room physician." At the time of this reporting [described as "at this point"), over a month after vaccination with hepatitis a vaccination and less than a month after completion of the VIVOTIF doses, the subject experienced watery stools and quality of life decreased. The subject reported that he was passing stool which was "extremely watery and filled with sediment" and his "quality of life has deteriorated extremely." The subject reported that he had "attempted to reduce the laxatives but that causes his system to cease up and not pass a bowel movement." The subject could not confirm that he had received HAVRIX. The subject reported the he "may send his request for reimbursement along with a pharmacy receipt. He also may be seeking legal action for compensation of his other expenses associated with these event." The subject was hospitalised. Relevant test results included bloodwork, 2 CT (computerized tomogram) scans, and 3 abdominal x-rays which "showed stool stuck in transverse colon" in August 2013. The subject was treated with MIRALAX, bisacodyl, COLACE, magnesium citrate, castor oil and lactulose. At the time of reporting the outcome of the events of injection site soreness, bruise injection site, and arm swelled at injection site were resolved. The outcome of the events of constipation were reported as improved by the subject. The outcome of the events of dehydrated, excessive night thirst, wakes up with dry mouth, watery stools and quality of life decreased were unknown.