Age: 75.0
Sex: U
Vaccine: FLU4, VARZOS
Symptoms: Constipation, Decreased appetite, Diarrhoea, Dizziness, Enema administration
Clinical narrative: This case was reported by a consumer and described the occurrence of gastroenteritis in a 75-year-old patient who received SHINGRIX for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2018-2019 season) for prophylaxis. The patient's past medical history included shoulder pain (received Cortisone injection on 21st June 2018.). On 29th August 2018, the patient received SHINGRIX and Influenza vaccine Quadrivalent 2018-2019 season. On 7th September 2018, 9 days after receiving SHINGRIX and Influenza vaccine Quadrivalent 2018-2019 season, the patient experienced gastroenteritis (serious criteria hospitalization), nausea (serious criteria hospitalization), back pain (serious criteria hospitalization) and renal pain (serious criteria hospitalization). On 8th September 2018, the patient experienced dizziness (serious criteria hospitalization), vertigo (serious criteria hospitalization), unable to walk (serious criteria hospitalization), loss of balance (serious criteria hospitalization), stomach discomfort (serious criteria hospitalization), body numbness (serious criteria hospitalization) and shivering (serious criteria hospitalization). On 9th September 2018, the patient experienced swelling (serious criteria hospitalization), absent bowel movement (serious criteria hospitalization) and pain. On 10th September 2018, the patient experienced vomiting (serious criteria hospitalization). In September 2018, the patient experienced contracture of hand joint (serious criteria hospitalization), shoulder bursitis, arthritis and feeling abnormal. On 16th September 2018, the patient experienced activities of daily living impaired. On 9th October 2018, the patient experienced diarrhea. On 29th October 2018, the patient experienced appetite absent. The patient was treated with ambiguous medication nos (Cortisone (Nos)), enema preparations (nos) (Enema (Nos)) and antibiotics nos. On an unknown date, the outcome of the gastroenteritis, back pain, renal pain, contracture of hand joint, unable to walk, stomach discomfort, body numbness, shivering, swelling, absent bowel movement, vomiting, shoulder bursitis, arthritis, feeling abnormal, pain, diarrhea and activities of daily living impaired were unknown and the outcome of the nausea, dizziness, vertigo, loss of balance and appetite absent were not recovered/not resolved. It was unknown if the reporter considered the gastroenteritis, nausea, back pain, renal pain, dizziness, vertigo, contracture of hand joint, unable to walk, loss of balance, stomach discomfort, body numbness, shivering, swelling, absent bowel movement, vomiting, appetite absent, shoulder bursitis, arthritis, feeling abnormal, pain, diarrhea and activities of daily living impaired to be related to SHINGRIX and Influenza vaccine Quadrivalent 2018-2019 season. Additional details were reported as follows: The patient received SHINGRIX and Flu vaccine and experienced nausea, terrible pain in back and kidneys. On 8th September 2018, 10 days after vaccination, the patient had numbness, shivering, felt very dizzy, couldn't walk and lost balance. Also experienced nausea, excruciating back and kidney pain, extremely tight feeling around stomach. The patient's whole body felt numb, right side of arm and hand was very numb. On Sunday, 11 days after vaccination, the patient was in agony with back and kidney pain. The pressure around mid section of body was swollen and very excruciating. The patient had no bowel movents for 9 days. The patient took suppositories, enema and prune juice but nothing worked. On Monday, 12 days after vaccination, the patient was in the same pain, then started vomiting. The patient felt like huge tyre gripped tight around the mid section of body. On the same day (10th September 2018), at 8 AM, the patient visited primary physician who recommended to go straight to emergency room (ER). The patient was put on intravenous (IV) steroids and antibiotics. Several physician's visited and at first they thought that the patient had stroke because of the numbness and crunched up hand, the fingers of which the patient could not straighten. During the 4 day in hospital, the patient underwent 5 Nuclear magnetic resonance imaging (MRI), 5 Magnetic resonance angiogram (MRA), 4 Computerised tomogram (CT sacan), Chest X-ray and an Angiogram. The 1st MRI done for blockage in stomach but nothing found. At that time chest X-ray, Angiogram of head and geography of neck. Another MRI of spine found arthritis. Another MRI of neck discovered nerve touching artery on the right side which could affecting the patient's balance. The patient thought that might have to had stent put in neck to relieve nerve. On 14th September 2018, the patient was discharged from hospital and was prescribed with two different types of antibiotics. The antibiotics made the patient felt like a Zombie and felt nauseous every day. The patient bought a Walker and Chair for shower. All physicians were confused about all symptoms. On 15th September nothing had changed and the patient felt terrible. On 16th September 2018, the patient was in agony all day and could not do anything, was totally incapacitated. On 17th September 2018, the patient back to emergency room 8:30 AM. In all day on drip had a scan to examine stomach. The physician advised that the patient had gastroenteritis and not a urinary tract infection (UTI).  The physician changed the patient's antibiotics for more appropriate ones. On 18th September 2018, during check-up, the primary physician suggested physiotherapy for balance and vertigo/dizziness. On 21st September 2018, the patient saw physician's assistant, who gave Cortisone injection for swollen bursa.On 25th September 2018, saw the physician but still feeling terrible, he suggested to go to another clinic which specializing in balance and vertigo. On 3rd October 2018, the patient underwent hearing test but nothing was reported. As per physician's opinion, the patient did not have vertigo and he thought that the patient had virus going through body causing all these problems, he suggested physiotherapy. On 4th October 2018, the patient had follow up appointment with orthopaedic specialist. The patient had seen this physician on 21st June 2018, and had Cortisone in shoulder for pain at that time to relieve pain. On 9th October 2018, the patient had terrible diarrhea and vomitting which went on for 8 days, the patient felt dizzy and had balance problems. On 29th October 2018, the patient still facing balance problems, nausea and no appetite. Lab Comments: During the 4 day in hospital, the patient underwent 5 Nuclear magnetic resonance imaging (MRI), 5 Magnetic resonance angiogram (MRA), 4 Computerised tomogram (CT sacan), Chest X-ray and an Angiogram. The 1st MRI done for blockage in stomach but nothing found. At that time chest X-ray, Angiogram of head and geography of neck. Another MRI of spine found arthritis. Another MRI of neck discovered nerve touching artery on the right side which could affecting the patient's balance. On 3rd October 2018, the patient underwent hearing test but nothing was reported.