Age: 1.3
Sex: F
Vaccine: DTAP, HIBV, MMR
Symptoms: Pruritus, Pyrexia, Rash, Rash erythematous
Clinical narrative: Information has been received from a registered nurse concerning a 15 month old white female with no known drug allergies and "no defects" with chronic rhinoantritis (yellow/green) with cough and with possible umbilical hernia, slight gross motor delay, lead exposure (renovation of patient's house) and diagnosed as "well".  On 10/08/1999 the patient was vaccinated with a first dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation).  Concomitant therapy included amoxicillin trihydrate (AMOXIL)(250 mg/5.0mL) for rhinoantritis.  Subsequently, the patient developed "rash or hives."  According to the patient's mother, "rash occurred 4 days after immunization-rash peaked after 7 days."  On 10/08/1999 the patient was given amoxicillin trihydrate (AMOXIL).  On 10/12/1999 the patient was seen in the doctor's office with "little red spots" on lower back and upper buttocks which were "thought bug bites at first, but keeps getting more."  There was no rash elsewhere or swelling of face or rash on face.  There was "no more trouble breathing than she has had cold symptoms."  The patient had received a dose of amoxicillin around 9:00AM.  The patient was instructed to observe if more spots appear, last to check if allergic rash."  On 10/16/1999 the patient had itchy eyes and nose.  The patient had a "mild rash on the abdomen, 4-5 raised bumps."  There was no fever.  The patient was treated with colloidal oatmeal (Aveeno) and diphenhydramine HCl (Benadryl)(3/4 tsp. <4-6h).  On 10/17/1999 the rash was reportedly "worse today," and was described as a "fine pinpoint rash," also described as "lots of small (2mm) slightly raised red rash-not urticaria."  The patient also had a "running temp 101-102."  It was noted that the rash was "from (measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation)) or Amoxil?" It was noted that a "(measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation)) reaction was mostly likely because of fever and myalgia."  "Not drug allergy," was also noted.  On 10/17/1999 the amoxicillin trihydrate (AMOXIL) was discontinued, "for now."  The patient was given ibuprofen (MOTRIN).  On 10/18/1999 the patient was using ibuprofen (MOTRIN) and dephenhydramine HCl (Benadryl) for rash.  The patient was "still covered-fussy."  The patient was given (Pediapred)(tsp BID 5d (50mL)).  On 10/20/1999 the rash improved.  It was reported that the patient recovered on 10/20/1999.  On 12/03/1999 the patient had a 'lump on back of neck-left side below her ear-bigger than pea-moveble." The diagnosis was "probable enlarged lymph gland."  On 12/20/1999 the patient had a low grade fever, runny nose and slight cough.  The patient had a nose bleed when up from nap.  On 08/16/2002 a physician reported that "it is not recommended that (the patient) be immunized for the second (measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation)).  Her antibody titers have been tested and she displays more than adequate immunity to measles and rubella.  due to her hyperimmunity it is a contraindication to administer this vaccination at this time."  It was noted that on 09/09/1998, 11/06/1998, 01/11/1999, and on 10/08/1999 the patient received a first, second and third and fourth dose of diphtheria toxoid/pertussis vaccine/ tetanus (ACEL-IMUNE), respectively.  On 09/09/1998, 11/06/1998, and on 07/12/1999 the patient received a first, second and third dose of a poliovirus vaccine, respectively.  On 09/09/1998, 11/06/1998, 01/11/1999, and on 10/08/1999 the patient received a first, second, third, and fourth dose of a HIB conjugate vaccine (manufacturer unknown), respectively.  On 07/09/1998, 08/10/1998, and on 01/11/1999 the patient received a first, second, and third dose of hepatitis B vaccine recombinant (yeast)(manufacturer unknown), respectively.  On 07/12/1999 the patient received a first dose of varicella virus vaccinelive (VARIVAX).  No further information is expected.