Age: 75.0
Sex: M
Vaccine: FLU3
Symptoms: Pneumonia, Tachypnoea
Clinical narrative: A 75 year old male received RSV vaccine of Placebo and Influenza vaccine in the RSV 11 study on Oct 10, 2002 and on June 18, 2003, 251 days later was admitted to impatient hospice for pain management of spinal stenosis OA. Patient's wife called to site to say patient had passed away July 11, 2003, 274 days after vaccination. The investigator assessed the event as unrelated to the study product. Further information has been requested.  On March 7, 2003 148 days after vaccination the patient developed pneumonia and was admitted to hospital on March 7, 2002. The patient was given steroids. From follow up information received April 4, 2003 the pneumonia symptoms were ongoing.Discharge summary for March 7, 2003 to March 12, 2003. Diagnosis: left lower lobe pneumonia, chronic obstructive pulmonary disease, coronary artery disease, diabetes, hyperlipidemia. Hospital course: The patient was admitted with shortness of breath. He was found to have a left lower lobe infiltrate on chest x-ray. He was treated with oxygen and IV tequin. Blood cultures werenegative. Sputum culture grew out only usual oral flora. The patient continued to have shortness of breath. Steroids were added. He had hyperglycemia related to that, but did ultimately improve. He leaves here with normal white count. He ias being discharged to home with medications as prior to admit. He was told that his blood sugars will improve as he is rapidly tapered off of his Prednisone. He will be on Tequin 400mg po qd for five more days and Prednisone 20/20,10/10,5/5 and then off. He will follow up with his primary care ohysician. It is recommended that in one to two weeks, he have a follow up chest x-ray to assure clearing of his infiltrate. From follow up information received June 6, 2003-Diagnosis left lower lobe pneumonia,COPD outcome recovered. From follow up information received June 22, 2003 : Emergency dept report 03/07/2003. This is a 75 year old male who presents to the emergency dept with his wife. He states that he has had a fever every night for the last two weeks. He was diagnosed with oneumonia in the first on March and just finished a Z pack and really dose not feel any better. He says he has been coughing up some grayish brownish sputum but today he has not been able to cough anything up. He just really feels miserable. He feels more miserable today than he has. He denies any chest pain. He denies any abdominal pain, denies any nausea, vomiting, diarrhea. He denies any extremity swelling. He feels generally weak and bad. Review of system: The review of sytems is otherwise negative. This is a well developed well nourished elderly male, resting on the cart. He appears tachypneic with some conversational dyspnea. Skin is warm and dry. There are no rashes or lesions. He appears well hydrated. HEENT Normocephalic, atraumatic. Eyes, ears, nose and mouth normal. Neck Supple and non tender. No obvious asymmetry or palpable mass. He has no increased jugular venous pressure noted. Hearts: regular rate and rythm. Lungs: significant for decreased air movements in his bases bilaterally. Abdomen Normoactive bowel sounds, soft, no palpabe masses or tenderness. No rebound, guarding or peritoneal signs. Extremities: no clubbing, cyanosis or edema.  Here in the emergency dept, chest x-ray, CBC comprehensive metabolic panel, blood cultures x 2. EKG were performed. His chest x-ray interpreted by myself was significant for right hilar infiltrate as well as what looks like a left lower extremity pneumonia. His white count is 10,200, hemoglobin and hematocrit 13.4 and 39.6 respectively with 211,000 platelets 77.2 % granulocytes, 7.9 absolute granulocytes on his differential. His glucose is elevated at 140 and otherwise all values on his comprehensive metabolic panel are within normal limits. EKG interpreted by myself is a normal sinus rhythm, rate 90, axis normal. Itervals are within normal limits. No evidence of acute injury, ischemia or infarction. Emergency dept course and interventi