chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 14.0
Sex: F
Vaccine: HEPA, MNQ, TYP
Symptoms: Dizziness
Clinical narrative: Patient was given Hep A and Typhoid when she started to feel light-headed. Patient was assisted to lie back and elevate feet and given an ice pack. Upon recovery, Menactra was administered to patient.
Age: 13.0
Sex: M
Vaccine: HEPA, MNQ, TDAP
Symptoms: Malaise, Syncope
Clinical narrative: While waiting 15 minutes in waiting room after vaccines were given. Pt said he didn't feel well and collapsed into arms of corpman. He was carried to gurney to rest for 30 minutes.
Sex: U
Vaccine: TDAP
Symptoms: Axillary pain, Chills, Headache, Injected limb mobility decreased, Muscle spasms
Clinical narrative: 2 days post vaccine.  Limited motion of left arm with vomiting, headache, fever & chills.  Left arm muscle spasms & twitching.  No visual difference in size of arms.  No redness or heat to site.  Complaints of arm pit soreness.  To see care at urgent care.  Client put on Zithromax, Medrol pack & Motrin.
Sex: U
Vaccine: TDAP
Symptoms: Muscle twitching, Pyrexia, Vomiting
Clinical narrative: 2 days post vaccine.  Limited motion of left arm with vomiting, headache, fever & chills.  Left arm muscle spasms & twitching.  No visual difference in size of arms.  No redness or heat to site.  Complaints of arm pit soreness.  To see care at urgent care.  Client put on Zithromax, Medrol pack & Motrin.
Age: 21.0
Sex: F
Vaccine: HPV4, TDAP
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Limb discomfort
Clinical narrative: Saw patient 4 days following immunization. Local induration, erythema 4" around vaccine site. C/O arm discomfort. Treated as cellulitis with Duricef since Benadryl for allergic reaction was not effective in decreasing symptoms.
Age: 1.3
Sex: F
Vaccine: DTAP, HIBV
Symptoms: Irritability, Pharyngitis, Pyrexia, Urine analysis normal
Clinical narrative: Received vaccines 4-25-08.  Started with a fever that afternoon, fussy.  4/28/08-Seen by doctor-pharyngitis.  Omnicef - Claritin started.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site swelling, Injection site warmth
Clinical narrative: Swelling, warmth at injection site, gradually increasing in 1st 48 hrs after IZ given.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Erythema, Induration, Skin warm
Clinical narrative: Left deltoid area red, warm to touch and slightly indurated x24 hours. Advised to apply ice intermittently to site x24 hours, given Tylenol and Motrin for age/wt and see PCP as ordered
Age: 39.0
Sex: F
Vaccine: TD
Symptoms: Induration, Injection site pain, Neck pain, Swelling, Tenderness
Clinical narrative: Two days later she stopped by office to show at the base of her neck, on the right side, patient has about 3x3 slightly swollen area, 1" area in the middle very firm.  Entire area "very tender". Patient states has been moving right arm "quite a bit" since receiving TD vaccine on 3/25/08.  Pain began "last night".  Pain runs from R deltoid, across shoulder, and up side of neck, no other c/o.  Instructed to call family MD.
Age: 0.64
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Blood test normal, Dyskinesia, Irritability, Rash, Rash erythematous
Clinical narrative: 4-25-08 Mother called and stated child has a fine pinpoint red rash on trunk.  Has been fussy for 24 hours but worse the first 12 hours.  Advised to consult MD.  5-1-08 followed up with Mother.  She stated had taken child to MD on 4-25-08.  The rash had extended up to neck and cheeks.  It just went away on 4-28-08.  No fever.  They did blood test, one being a strept, which was negative.  They put the child on antibiotics (Keflex).  Stated they were checking her for Chorieformic movements because she also at the time of the rash developed "shimmy movements" like a cold chill twitch where she would knock herself over when sitting up.  To follow up with MD on 5-5-08. Follow-up Information 20-JUN-2008: The client saw a neurologist. The child continues with movements and the neurologist has told the parent that "too many vaccines at once triggered a resonse, not a reaction to a specific vaccine, but the amount of vaccines given." He has recommended that the child receive only one vaccine at a time in the future. I need to update that the client saw a neurologist. the child continues with movements and the neurologist has told the parent that " too many vaccinees at once triggered a response, not a reaction to a specfic vaccine, butthe amount of vaccines diven." He has recommeneded that the child recieve only one vaccine at a time in the future.
Age: 0.64
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Streptococcal identification test negative
Clinical narrative: 4-25-08 Mother called and stated child has a fine pinpoint red rash on trunk.  Has been fussy for 24 hours but worse the first 12 hours.  Advised to consult MD.  5-1-08 followed up with Mother.  She stated had taken child to MD on 4-25-08.  The rash had extended up to neck and cheeks.  It just went away on 4-28-08.  No fever.  They did blood test, one being a strept, which was negative.  They put the child on antibiotics (Keflex).  Stated they were checking her for Chorieformic movements because she also at the time of the rash developed "shimmy movements" like a cold chill twitch where she would knock herself over when sitting up.  To follow up with MD on 5-5-08. Follow-up Information 20-JUN-2008: The client saw a neurologist. The child continues with movements and the neurologist has told the parent that "too many vaccines at once triggered a resonse, not a reaction to a specific vaccine, but the amount of vaccines given." He has recommended that the child receive only one vaccine at a time in the future. I need to update that the client saw a neurologist. the child continues with movements and the neurologist has told the parent that " too many vaccinees at once triggered a response, not a reaction to a specfic vaccine, butthe amount of vaccines diven." He has recommeneded that the child recieve only one vaccine at a time in the future.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Antibody test negative, Ascites, Biopsy kidney abnormal, Bronchoscopy, Chromaturia
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Cytomegalovirus antibody negative, Diffuse alveolar damage, Dyspnoea, Generalised oedema, Glomerulonephropathy
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Histology, Nephrotic syndrome, Oedema, Pleural effusion, Purpura
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Respiratory distress, Rheumatoid factor positive, Streptococcal identification test negative, Syphilis test negative, Virus culture
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Arthralgia, Biopsy bronchus abnormal, Biopsy kidney abnormal, Bronchoalveolar lavage abnormal, Bronchoscopy
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Chest X-ray normal, Computerised tomogram thorax abnormal, Cough, Diffuse alveolar damage, Glomerulonephritis rapidly progressive
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Haemoptysis, Henoch-Schonlein purpura, Inflammation, Macrophages increased, Oedema peripheral
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Pain, Pitting oedema, Pleural effusion, Proteinuria, Pulmonary alveolar haemorrhage
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Rash erythematous, Renal failure acute, Respiratory distress
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Acute respiratory distress syndrome, Arthralgia, Biopsy kidney abnormal, Biopsy lung, Bronchial haemorrhage
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Bronchoalveolar lavage abnormal, Bronchoscopy, Chest X-ray normal, Computerised tomogram abnormal, Cough
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Diffuse alveolar damage, Glomerulonephritis rapidly progressive, Haemoptysis, Henoch-Schonlein purpura, Inflammation
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Laboratory test abnormal, Lung infiltration, Macrophages increased, Oedema peripheral, Pain
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Pitting oedema, Pleural effusion, Proteinuria, Pulmonary haemosiderosis, Rash erythematous
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 26.0
Sex: M
Vaccine: HEP, HEP, HEP
Symptoms: Rash papular, Renal failure acute
Clinical narrative: Patient developed purpuric rash 2 weeks after given Hep B vaccine on 7 Feb 2008.  Over subsequent 2 weeks developed edema and red colored urine and he developed acute respiratory distress 19 March.  Pt was then admitted through 28Mar to MC and underwent bronchoscopy which revealed hemosiderin laden macrophages c/w DAH.  Pt underwent renal bx 21Mar08 and was diagnosed with a crescentric glomerulonephropathy > 60% crescents, marked interstitial edema, non-specific immune staining for IgA, IgG and C3, no TRI's. Pt's clinical symptoms were both nephritic and nephrotic, (nephritic sediment with > 9 g protein excreted daily).   ANA/ENA, dsDNA, ANCAs, anti-GBM, Hep C viral load, HIV all negative.  C3 low, C4 normal, C2 low.    Patient underwent pulse Solumedrol 1 gram IV x 3 days, then 60 mg oral qd.  Patient readmitted 2-7 April for worsening edema and dyspnea.  Evaluation at that time revealed worsening nephrosis, serum albumin 1.5, massive anasarca, pleural effusions, ascites, and creatinine 3.0 mg%.  Patient pulsed again with 500 mg Solumedrol x 3 and given 1.0 grams cyclophosphamide IV on 4 April.   Pt has had progressive anasarca and treated with lasix, albumin and metolazone on 17Apr08. Continued on prednisone 200 mg qod. Began plasmapheresis on 24Apr08 1.25 plasma volumes x 3 sessions.  07/11/2008 MR received for 2 admissions DOS 3/19-28/2008 and 3/28-29/2008 with D/C DX:  Henoch-Schonlein Purpura and Microangiopathic Hemolytic Anemia. Subendocardial ischemia. Pt initially presented as an outpt with c/o 3 week hx of bilateral lower extremity swelling with rash around the ankles which began 3 days s/p Hep B vax. Thought to be HSP and treated with steroids, although full course not taken.  pt presented for admission with dyspnea, non-productive cough, chills and hot spells. Pt still with c/o swelling of feet and rash which had decreased from thigh level back to ankles.  PE (+) for 4/5 strength, tremor with arm raise, 3+ pedal edema to ankle bilat. Coarse breath sounds noted. Purpuric rash now macular to medial ankles. Pt admitted in Acute Renal Failure showing early respiratory distress and worsening renal failure from shock vs multilobar pneumonia. Renal fxn declined during admit. Tx with Solumedrol with improving respiratory fxn. D/C for outpt plasma apheresis, however halfway through tx pt developed sharp, substernal chest pain and light-headedness and SOB. Pt hypertensive.  Admitted again for PRBC transfusion with improvement in sx.
Age: 24.0
Sex: F
Vaccine: HEP, TDAP
Symptoms: Injected limb mobility decreased, Injection site pain
Clinical narrative: pain, tenderness at injection site in left deltoid; difficulty moving left arm two days after receiving injection
Age: 1.0
Sex: M
Vaccine: VARCEL, VARCEL
Symptoms: CSF test, Headache, Herpes zoster, Meningitis, Pleocytosis
Clinical narrative: Patient was transfered to our facility after developing severe headache, meningitis in setting of zoster of left upper arm (site of previous vaccination 7 years prior).   CSF had pleocytosis and was PCR + for VZV at outside facility, negative at our facility after 3 days of acyclovir intervenously.   Isolate subsequently identified as vaccine-strain from both arm lesions and CSF. 6/26/08-recoreds received for DOS 6/14-6/20/07-DC DX: VZV meningitis. Presented with headache and photophobia. 9 days PTA itchy lesion on left shoulder which spread into vesicular rash over next 2 days. 6 days PTA diagnosed with shingles. 5 day PTA developed severe headache, neck stiffness, photophobia vomiting, sleepy.
Age: 1.0
Sex: M
Vaccine: VARCEL, VARCEL
Symptoms: Polymerase chain reaction, Viral DNA test positive
Clinical narrative: Patient was transfered to our facility after developing severe headache, meningitis in setting of zoster of left upper arm (site of previous vaccination 7 years prior).   CSF had pleocytosis and was PCR + for VZV at outside facility, negative at our facility after 3 days of acyclovir intervenously.   Isolate subsequently identified as vaccine-strain from both arm lesions and CSF. 6/26/08-recoreds received for DOS 6/14-6/20/07-DC DX: VZV meningitis. Presented with headache and photophobia. 9 days PTA itchy lesion on left shoulder which spread into vesicular rash over next 2 days. 6 days PTA diagnosed with shingles. 5 day PTA developed severe headache, neck stiffness, photophobia vomiting, sleepy.
Age: 1.0
Sex: M
Vaccine: VARCEL, VARCEL
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Bacterial infection, Blister, CSF culture positive
Clinical narrative: Patient was transfered to our facility after developing severe headache, meningitis in setting of zoster of left upper arm (site of previous vaccination 7 years prior).   CSF had pleocytosis and was PCR + for VZV at outside facility, negative at our facility after 3 days of acyclovir intervenously.   Isolate subsequently identified as vaccine-strain from both arm lesions and CSF. 6/26/08-recoreds received for DOS 6/14-6/20/07-DC DX: VZV meningitis. Presented with headache and photophobia. 9 days PTA itchy lesion on left shoulder which spread into vesicular rash over next 2 days. 6 days PTA diagnosed with shingles. 5 day PTA developed severe headache, neck stiffness, photophobia vomiting, sleepy.