Age: 65.0
Sex: F
Vaccine: PPV, PPV
Symptoms: Cardiac murmur, Computerised tomogram head normal, Echocardiogram normal, Electrocardiogram abnormal, Hypersensitivity
Clinical narrative: This spontaneous report as received from a nurse refers to a 65 year old female patient. Information about concurrent conditions, concomitant medication and medical history was not provided. On an unknown date the patient was vaccinated with PNEUMOVAX 23 (injection, dose route and frequency were not provided). The patient then called the physician's office on an unspecified date and stated that she, the patient, had an unspecified allergic reaction to the PNEUMOVAX 23 and visited an unspecified emergency room. The patient was not admitted to the hospital. The patient also stated that she did not feel well after receiving the vaccine. The outcome of the events was not provided. Additional information was received from medical records concerning a female who on 23-SEP-2014 was vaccinated with a dose of PNEUMOVAX 23 lot # K004930, expiration date 16-MAR-2015 (site location only reported as right) at 1515. The patient is a 65 year old female (136 pounds, 68 inches), non-smoker with allergies to phenothiazines, ZITHROMAX, morphine, BIAXIN, sulfonamides, CECLOR, CIPRO, DORYX, penicillins, KEFLEX and vancomycin. Patient with the following active conditions: Diabetes mellitus Type I, Sicca syndrome, hypothyroidism, Sjogren's syndrome, abrasion foot and toe without infection, acute laryngopharyngitis, anemia, cellulitis and abscess foot, celiac disease, diabetic retinopathy, gastroparesis, hypercholesterolemia, hypertension, nephrotic syndrome, osteomyelitis ankle and foot, osteoporosis, syncope and collapse, local infection skin subcutaneous tissue, diabetes circulatent disorder type I, hyperlipidemia, vasculitis and methicillin susceptible staphylococcus aureus. Patient with past history of appendectomy, cataract surgery, amputation right second toe, sinus surgery, and laser retinal surgery for retinopathy. Family history of cardiovascular disorder and diabetes. Concomitant therapies included RESTASIS, SURFAK, CRESTOR, MUCINEX, LEVEMIR, Domperidone, quinapril hydrochloride, DIOVAN, MEDROL, PRILOSEC, PROMETRIUM, Estradiol, NASONEX, HUMALOG, LASIX, ZETIA, SYNTHROID, MAGINEX, minerals (unspecified), CENTRUM SILVER, CITRICAL, ascorbic acid, ergocalciferol, cupric oxide, vitamin E, xanthophyll, PRESERVISION with lutein and FIBER CHOICE. On 24-SEP-2014, the patient was brought to the emergency room by ambulance. The patient stated she woke up to take her blood sugar, sat at the bottom of the bed and passed out. On physical exam the physician noted that patient was in no acute distress, her heart rate was regular with systolic murmur. The patient was admitted to the medical floor with syncope, probably secondary to PNEUMOVAX inoculation. The patient was seen by cardiologist who felt syncope could be related to vasovagal syncope versus orthostatic hypertension. The physician noted that the patient has long standing diabetes mellitus which could cause automatic dysfunction. The patient electrocardiogram (ECG) showed sinus bradycardia. An echocardiogram was completed and revealed normal left ventricular size, function and wall motion; normal valvular structures no evidence of pulmonary hypertension and normal pericardial structure. Computerized tomogram (CT) of the head revealed no evidence of acute hemorrhage or mass effect. The patient had no further episodes of syncope while hospitalized and her blood sugars under reasonable control. Final diagnosis was reported as syncope thought to be secondary to a reaction from her PNEUMOVAX inoculation. The patient has a full time home care nurse and was discharged on 25-SEP-14 and will follow up with physician in two weeks. Additional information has been requested.