Age: 5.0
Sex: M
Vaccine: FLUN3
Symptoms: Laboratory test normal, Muscular weakness, Nerve conduction studies, Nuclear magnetic resonance imaging brain, Nuclear magnetic resonance imaging spinal abnormal
Clinical narrative: This report to VAERS provides the following narrative: This case has been received from Regulatory Authority (VAERS) concerning a 5 year old male patient. No concomitant medication and no medical history were provided. The patient had been receiving FLUMIST (intranasal) started on an unknown date. The study subject was a 5-year-old male who was seen in the urgent clinic on 21-Sep-09 for fever, increased sleepiness and leg pain for the last two days. His pain started in the feet progressing to the legs and then to his groin area. He was having difficulty walking. The pain was relieved with MOTRIN. One day prior to this urgent care visit he developed fever up to 101 F. Review of system was remarkable for new onset of runny nose and cough for the last several days and occasional back pain. Patient was admitted to Hospital on 21-Sep-2009. PE was remarkable for temperature of 102F and an alert boy in no acute distress. Positive finding were increase warmth of both lower extremities, pain in weight bearing, full range of motion of hips, knees and ankle joints, and point tenderness upon palpation of the calves and groin bilaterally. He had normal sensation and his deep tendon reflexes were difficult to elicit. Cranial nerves II-XII were intact. X-ray of the hip was normal, sed rate was 18 and CRP was elevated at 10.5. CBC with differential, chemistry panel and liver enzyme panel were within normal limits. Respiratory panel by Qiagen Q1Aplex PCR was negative for influenza A and B, RSV, PIV types 1-4, hMPV, rhinovirus, adenovirus, bocavirus, coronavirus and enteroviruses. CSF fluid was negative by PCR for enteroviruses. CSF fluid: no WBC, no RBC, glucose 63 mg/dl and protein 16.8 mg/dl. CSF culture was sterile for organisms. MRI of brain and cervical, thoracic and lumbar spine with and without contract did not reveal any abnormal pathology. A neurology consult was obtained on the second hospital stay. There was no definitive progression of leg weakness and with minimal inflammatory marker elevation. CK was elevated at 1094 U/ml. Nerve conduction study performed on 24 September demonstrated mild decreased amplitude of the peroneal compound motor action bilaterally without an F wave response. The peroneal distal motor latencies and motor nerve conduction were normal. The left peroneal, left median and left ulnar F-wave responses were not obtained although the remainder of the F wave responses was easily obtained with normal latencies. Patient received IVIG on 24-September and 25-September. Patient was discharged home on 27-Septebmer-2009. Final diagnosis: Guillain-Barre. Discharge medication: LYRICA 1/2 capsule (25mg/capsule) twice a day for pain as needed 12/2009 Urgent Care, ED and Hospital Records received for DOS 9/21/09-09/27/09. Pt admitted with ascending paralysis, pain in legs x2 days, fever, bilateral LE weakness, blunted ankle and knee reflexes, headache, sleepiness. Received IVIG x2. Pediatric neurology consult obtained. Continued to improve and dc home. DC DX: Guillain-Barre syndrome. The outcome of the event of Guillain-Barre syndrome was unknown. The reporter assessed the event Guillain-Barre syndrome to be serious with the seriousness criteria of Hospitalization.