Age: 40.0
Sex: F
Vaccine: MMR
Symptoms: Dry mouth, Echocardiogram, Fatigue, Laboratory test, Lymphadenopathy
Clinical narrative: 10 days p/vax pt exp fever 103, glands in neck very swollen, dizziness, myalgia & joint pain x 3 days;ongoing dizziness, fatigue;extreme dry mouth until present time. Information has been received from a consumer, a 41-year-old Caucasian female with a history of a fall in 1995 which resulted in "some" cervical damage, endometriosis, and an appendectomy who on 10-FEB-1998 was vaccinated SC with PROQUAD. Concomitant therapy included propoxyphene (+) acetaminophen. On 11-FEB-1998 the patient experienced a left dilated pupil. On 20-FEB-1998 the patient experienced a fever 104-105 degrees F x 2.5 days. At this time, the patient experienced severe shortness of breath, which lasted until April 1998. Additionally, the patient noted "right side of face and neck blew up." The swelling lasted for five days. The patient noted that the inside of her mouth peeled and that she had "no saliva." The patient noted that "the no saliva continues at this time." The patient sought unspecified medical treatment. A physician labeled the eye problem "Adie's Pupil" and said that it was related to a virus. In March 1998 the patient "was given steroids and had mononucleosis." In April 1998 "vision returned to the left eye." The patient further noted "right eye is now beginning to cause problems and will dilate and stay that way for about a day and then return to normal."The patient also has lost 40 pounds. Follow-up information from a physician indicated that the patient received PROQUAD in February, 1998. "After this, the patient developed facial edema and actually developed mumps and mononucleosis. Since that time the patient has had become more severely constiped and has lost 25 pounds, not purposely, although with the decreased salivation she is probably eating less. The patient does have odynophagia with the feeling and sensation of some discomfort of food going down her esphagus. The patient had one episode of vomiting, no nausea. She sometimes goes a week without having a bowel movement which is definitely a change for her. The patient has also seen some bright red blood in her stool which is also new. When her initial symptoms started in February, she had some shortness of breath as well. The patient had dyspnea on exertion and an echocardiogram and chest x-ray were done which were all normal. Additionally, it was noted that the patient's husband works with many pesticides and other chemicals and she does clean his clothes and is exposed to some of these chemicals. A physicain noted, "This is a somewhat interesting story which suggests some type of anticholinergic phenomenon, particularly given the constipation and dry mouth. Temporarily it seems to be related to the MMR shot, although I would have expected this to ohave resolved by now. GI wise, the weight loss is a problem, as is the new constipation and difficulty swallowing, again which may all be related to an anticholinergic effect, decreased salivation, etc. I am wondering about exposure to chemicals, particularly pesticides which may have some of her proble." Additional follow-up indicated that the patient is now on therapy with PROPULAID and is "not as constipated." Additional information has been requested.