chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 31.0
Sex: F
Vaccine: FLU4
Symptoms: Stevens-Johnson syndrome, Toxic epidermal necrolysis, Upper respiratory tract infection, Urinary tract infection
Clinical narrative: 31 year old patient with no significant past medical history received the influenza vaccine on 9/28. On 10/1 she had URI type symptoms and a rash around her eyes for which she started Durezol and tobramycin eye drops. She also began noticing a rash on her face. On 10/2 she went to an urgent care where she was diagnosed with a UTI and started oral Augmentin and received a Decadron shot. On 10/5 she was admitted to the hospital with a rash concerning Stevens-Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN). The patient complained of eye pain due to swelling and blisters, oral ulcers, dysphagia/odynophagia and had difficulty swallowing. The patient also had anal and genital blisters/sloughing. A biopsy was positive for TEN and it was noted the influenza vaccine was the possible inciting event. Patient had 30% skin involvement with a skin biopsy showing full epidermis necrosis consistant with TEN. Patient was treated supportively as well as received IVIG. Patient was given aggressive fluid resuscitation w/ continued monitoring. Patient managed in MICU initially requiring vasopressors and intubation. Patient progressed well, was extubated and transferred to general medicine unit. The patient continued to progress with continued supportive care and was discharged on 11/7/16.
Age: 54.0
Sex: F
Vaccine: FLU3, VARZOS
Symptoms: Erythema, Pruritus, Swelling
Clinical narrative: Redness, swelling, itching going down the arm that began the day following administration. Patient taking daily antihistamines to treat symptoms.
Age: 68.0
Sex: F
Vaccine: PPV, VARZOS
Symptoms: Body temperature increased, Injection site induration, Injection site pain, Injection site swelling, Rash
Clinical narrative: Painful, swollen, and hard bump on inner arm, near bicep for about 3-4 days. Bump was not at injection site. Rash about 4 days. Temperature of 100 degrees F at night and 99 degrees F during the day. Symptoms lasted about 4-5 days and pt. has full recovered.
Age: 65.0
Sex: M
Vaccine: VARZOS
Symptoms: Herpes zoster
Clinical narrative: Outbreak of T10 right sided shingles after given ZOSTAVAX 12/29/16.
Sex: M
Vaccine: VARCEL
Symptoms: No adverse event, Wrong drug administered
Clinical narrative: This spontaneous report as received from a nurse refers to a 62-year-old male patient. No information regarding the patient's pertinent medical history, drug reactions or allergies and concomitant therapies was provided. On 09-JAN-2017, the patient was mistakenly given a dose of VARIVAX (dose, route of administration, lot# and expiration date were not reported) instead of ZOSTAVAX. No adverse effect was reported. Additional information has been requested.
Sex: U
Vaccine: VARCEL
Symptoms: Incorrect product storage, No adverse event
Clinical narrative: This spontaneous report was received from a registered nurse referring to unspecified patients of unknown age and gender. The patients' pertinent medical history, drug reaction/allergies or concomitant medication were not reported. On unknown dates, the patients were vaccinated with improperly stored doses of VARIVAX lot # L026408 with expiration date: 15-JUL-2017 (doses and routes of administration were not reported) for prophylaxis. There were no adverse effects reported. The administered doses of vaccine experienced a temperature excursion of more than 5 Fahrenheit but less than 14 Fahrenheit for 3 hours. There was no Data logger involved or previous temperature excursion reported. There was no product quality complaint (PQC) involved. Additional information has been requested.
Age: 63.0
Sex: M
Vaccine: FLU3
Symptoms: Computerised tomogram head, Dysarthria, Dysphagia, Dyspnoea, Eyelid ptosis
Clinical narrative: Patient had drooping eyelids, occasional blurred vision, trouble swallowing, slurred speech, all over body was tired. Trouble breathing.
Age: 63.0
Sex: M
Vaccine: FLU3
Symptoms: Fatigue, Nuclear magnetic resonance imaging brain, Vision blurred
Clinical narrative: Patient had drooping eyelids, occasional blurred vision, trouble swallowing, slurred speech, all over body was tired. Trouble breathing.
Age: 0.17
Sex: M
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Enema administration, Intussusception, Ultrasound abdomen
Clinical narrative: Intussusception.
Age: 85.0
Sex: F
Vaccine: PNC13
Symptoms: Tinnitus
Clinical narrative: Patient has experienced ringing in her ears ever since the day after she received her PREVNAR vaccination.
Sex: U
Vaccine: RV5
Symptoms: Incorrect product storage, No adverse event
Clinical narrative: This spontaneous report was received from a registered nurse and refers to an unspecified number of patients of unknown ages and genders. No information regarding the patients' medical history, concomitant medications, concurrent conditions and drug reactions or allergies was provided. On 02-JAN-2017, the patients were vaccinated with improperly stored doses of ROTATEQ orally (dose, was not reported; lot # M007125, expiration date: 06-OCT-2017 and lot # M007298, expiration date 19-NOV-2017). The vaccine underwent a temperature excursion of 24 degrees Celsius for 56 minutes , which was detected by a digital data logger. No previous temperature excursions were reported. No product quality complaint (PQC) was involved. No adverse events were reported. This is one of the several reports received from the same reporter. Additional information is not expected as there was no consent for further contact.; Sender's Comments: US-009507513-1701USA012094:
Sex: U
Vaccine: RV5
Symptoms: Incorrect product storage
Clinical narrative: This spontaneous report was received from a medical assistant and refers to a patient of unknown age and gender. No information regarding the patient's pertinent medical history, drug reactions or allergies and concomitant therapies was provided. On an unknown date, the patient was administered an improperly stored ROTATEQ, oral liquid, orally, lot # M016238 with an expiration date of 07-DEC-2017 (dose was not reported). Administered vaccine underwent the temperature excursion of 52.8 degrees Fahrenheit (F) for 40 minutes which was detected by a data logger. The previous temperature excursion was not reported. Additional information has been requested.
Sex: F
Vaccine: HPV9
Symptoms: Haematoma, Haematoma evacuation
Clinical narrative: Information has been received from a Nurse practitioner via a Company representative concerning to a 13 year old female patient. On 06-DEC-2016, the patient was vaccinated with dose 1 of GARDASIL 9 (site, route and lot number not reported) for prophylaxis. In December 2016 (reported as "shortly after the GARDASIL injection, (unspecified date)"), the patient developed an hematoma. On 28-DEC-2016, the patient sought medical attention and was referred to a surgeon. On an unknown date, the surgeon removed from the hematoma, "15 cc's" of fluid. The patient did not die, had no Cancer, no disability, no hospitalization, no life threatening nor overdose. At the time of the report the outcome of hematoma was unknown. No product quality complaint was involved. The reporter stated that the patient's Pediatrician considered that the hematoma was not related to GARDASIL 9. Additional information has been requested.
Sex: U
Vaccine: HIBV
Symptoms: Incorrect product storage, No adverse event
Clinical narrative: This spontaneous report was received from a registered nurse and refers to an unspecified number of patients of unknown ages and genders. No information regarding the patients' medical history, concomitant medications, concurrent conditions and drug reactions or allergies was provided. On 02-JAN-2017, the patients were vaccinated with improperly stored doses of LIQUID PEDVAXHIB (dose, frequency and administration route were not reported; lot # M032148, expiration date 18-APR-2019). The vaccine underwent a temperature excursion of 24 degrees Celsius for 56 minutes , which was detected by a digital data logger. No previous temperature excursions were reported. No product quality complaint (PQC) was involved. No adverse events were reported. This is one of the several reports received from the same reporter. Additional information is not expected as there was no consent for further contact.; Sender's Comments: US-009507513-1701USA001541:
Age: 1.0
Sex: F
Vaccine: HEPA, HIBV, MMRV, PNC13
Symptoms: Irritability, Pyrexia, Seizure, Skin warm
Clinical narrative: Mother of PT stated. Daughter was very fussy, took a nap, felt warm. Woke up from her nap at 10:00 AM, and began nursing from mother. Then she started having a seizer. PT was taken to local ER with a fever of 102.3F. Mother says no fevers since the 01/22/2017.
Age: 68.0
Sex: F
Vaccine: FLUA3, PNC13, FLUA3, PNC13
Symptoms: Diarrhoea, Dizziness, Headache, Nausea, Pain
Clinical narrative: Nausea, vomiting, diarrhea, headache, soreness, vertigo, dizziness...started at 3:30am and continuing.
Age: 68.0
Sex: F
Vaccine: FLUA3, PNC13, FLUA3, PNC13
Symptoms: Vertigo, Vomiting
Clinical narrative: Nausea, vomiting, diarrhea, headache, soreness, vertigo, dizziness...started at 3:30am and continuing.
Age: 24.0
Sex: M
Vaccine: FLUX
Symptoms: Immediate post-injection reaction, Injection site pain, Musculoskeletal pain, Myalgia
Clinical narrative: Immediate shoulder pain after injection. Unlike prior influenza vaccination soreness. Pain was worse the following morning and has not gotten better.
Age: 68.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site induration, Injection site nodule, Injection site swelling
Clinical narrative: Patient woke up with a hard knot at injection site, redness, and swelling. Doctor prescribed an antibiotic treatment.
Age: 45.0
Sex: F
Vaccine: VARCEL
Symptoms: Pain in extremity
Clinical narrative: PAIN LEFT ARM.
Sex: U
Vaccine: HPVX, MENB
Symptoms: Pyrexia
Clinical narrative: This is a spontaneous report from a contactable physician received via a sales representative. A patient of unspecified age, race and gender received TRUMENBA, via an unspecified route of administration at single dose and HPV9, via an unspecified route of administration, both on an unspecified date for immunisation. The patient medical history and concomitant medications were not reported. The patient experienced high fever (40.5 Celsius) for 2 hours on an unspecified date with outcome of unknown.
Sex: U
Vaccine: HPVX, MENB
Symptoms: Pyrexia
Clinical narrative: This is a spontaneous report from a contactable physician via Pfizer sales representative. A patient of unspecified age, race and gender received TRUMENBA, via an unspecified route of administration at single dose and HPV9, via an unspecified route of administration, both on an unspecified same date for immunisation. The patient medical history and concomitant medications were not reported. The patient experienced high fever (40.5 Celsius) for two hours after administration on an unspecified date with outcome of unknown.
Sex: F
Vaccine: FLUC4, PPV
Symptoms: Acne, Contusion, Erythema, Injection site erythema, Injection site swelling
Clinical narrative: This spontaneous report received from a pharmacist referred to a 71 year old female patient. The patient's medical history, concurrent conditions were not reported. Historical drug included PREVNAR 13 which taken on an unknown date in 2015. On 21-OCT-2016, the patient was vaccinated with influenza virus vaccine inactivated (unspecified) (FLU SHOT) and in the opposite arm the patient was vaccinated with PNEUMOVAX 23 (lot number: L027732, expiry date: 23-FEB-2017) (dose and route were not reported). The patient's arm that received PNEUMOVAX 23 had redness and swelling that extended to her back and a bruise under her arm that began 1 or 2 days after the injection that worsened after 3 to 4 days. The redness continued and was present a week ago. The patient also experienced pimples on her abdomen and the front of her legs that began on an unspecified date that improved with BENADRYL taken on unspecified dates. The patient went to an unspecified urgent care center on 23-OCT-2016. The event pimples was resolving. It was unknown of her present status or if she had recovered from the other events. Causality assessment was not reported. Follow up information was received on 09-JAN-2017 from a pharmacist who refers to a 71 year old female patient with a history of codeine allergy that causes hypertension. On 21-OCT-2016 at 10:40, the patient was vaccinated with PNEUMOVAX 23 (lot number: L027732), IM, right deltoid (dose not reported) and FLUCELVAX (lot # 185888, manufactured by Seginus) IM, left deltoid, yearly (dose not reported). The patient had no illness at the time of her vaccination. On 22-OCT-2016, the patient's right arm  that received PNEUMOVAX 23 became red, hot, swollen from elbow up to her shoulder and across part of her back. She also experienced a large bruise on her inner arm. Two weeks later, on 11-NOV-2016, the patient reported she went to her doctor last week and the doctor recommended she take ZYRTEC which she took for one week. The patient's symptoms resolved on 11-NOV-2016. This is one of the two reports received from the same reporter. Additional information has been requested.; Sender's Comments: MERCK 1611USA006698:Mfr number.
Sex: F
Vaccine: FLUC4, PPV
Symptoms: Injection site warmth, Skin warm, Swelling
Clinical narrative: This spontaneous report received from a pharmacist referred to a 71 year old female patient. The patient's medical history, concurrent conditions were not reported. Historical drug included PREVNAR 13 which taken on an unknown date in 2015. On 21-OCT-2016, the patient was vaccinated with influenza virus vaccine inactivated (unspecified) (FLU SHOT) and in the opposite arm the patient was vaccinated with PNEUMOVAX 23 (lot number: L027732, expiry date: 23-FEB-2017) (dose and route were not reported). The patient's arm that received PNEUMOVAX 23 had redness and swelling that extended to her back and a bruise under her arm that began 1 or 2 days after the injection that worsened after 3 to 4 days. The redness continued and was present a week ago. The patient also experienced pimples on her abdomen and the front of her legs that began on an unspecified date that improved with BENADRYL taken on unspecified dates. The patient went to an unspecified urgent care center on 23-OCT-2016. The event pimples was resolving. It was unknown of her present status or if she had recovered from the other events. Causality assessment was not reported. Follow up information was received on 09-JAN-2017 from a pharmacist who refers to a 71 year old female patient with a history of codeine allergy that causes hypertension. On 21-OCT-2016 at 10:40, the patient was vaccinated with PNEUMOVAX 23 (lot number: L027732), IM, right deltoid (dose not reported) and FLUCELVAX (lot # 185888, manufactured by Seginus) IM, left deltoid, yearly (dose not reported). The patient had no illness at the time of her vaccination. On 22-OCT-2016, the patient's right arm  that received PNEUMOVAX 23 became red, hot, swollen from elbow up to her shoulder and across part of her back. She also experienced a large bruise on her inner arm. Two weeks later, on 11-NOV-2016, the patient reported she went to her doctor last week and the doctor recommended she take ZYRTEC which she took for one week. The patient's symptoms resolved on 11-NOV-2016. This is one of the two reports received from the same reporter. Additional information has been requested.; Sender's Comments: MERCK 1611USA006698:Mfr number.
Sex: F
Vaccine: VARZOS
Symptoms: Herpes zoster
Clinical narrative: Information was received from a physician via a company representative concerning a female patient of unknown age. No information was provided regarding the patient's medical history or concomitant medications.  On an unknown date, the patient was vaccinated with ZOSTAVAX injection (lot number, dosage, route of injection not provided).  The patient developed shingles on an unspecified date after receiving ZOSTAVAX.  The patient sought medical attention by her physician (no treatment information reported).  The outcome of the shingles is unknown. No further information was reported. Additional information has been requested.
Age: 0.33
Sex: F
Vaccine: HIBV, PNC13
Symptoms: Diarrhoea haemorrhagic
Clinical narrative: This is a spontaneous report from a contactable nurse. A 4-month-old female patient received on 18Jan2017 first dose of PREVNAR 13, lot number N44209, expiry date 31Oct2017, NDC number 00005-1971-02) at 0.5 ml single dose intramuscular for immunization.  Medical history included ongoing milk allergy since birth. Concomitant medications were none. On 18Jan2017, the patient had bloody diarrhea and was taken to the emergency room on the same date. The reporter did not think that the patient was admitted into the hospital. Outcome was unknown. Sender's Comments: Based on the information currently available, a causal relationship between the administration of PREVNAR 13 and the occurrence of the reported event cannot be completely excluded based on the temporal relationship.
Sex: M
Vaccine: PNC13
Symptoms: Pneumococcal sepsis
Clinical narrative: This is a spontaneous report from a contactable physician via Pfizer Sales representative. A 70-year-old male patient received a single dose of PREVNAR 13 on 01Nov2016 for immunisation. The patient medical history and concomitant medications were not reported. Two years before (in 2014) the patient took PNEUMOVAX for immunization.The patient developed pneumococcal sepsis on 22Dec2016 with outcome of unknown. Sender's Comments: Based on the information provided in the case, a lack of efficacy with PREVNAR 13 in this patient cannot be excluded. Further information like serotyping results is needed for a full medical assessment.
Sex: U
Vaccine: MENB
Symptoms: Chills, Fatigue, Headache, Pyrexia
Clinical narrative: This is a spontaneous report from a non-contactable nurse received via a sales representative. A patient of unspecified age, race and gender received TRUMENBA, via an unspecified route of administration at single dose in Apr2012 (first dose) and in Jul2013 (second dose) for immunisation. The patient medical history and concomitant medications were not reported. The patient experienced fatigue, chills, fever and headache for two days after shots. The final outcome was unknown.   No follow-up attempts possible. No further information expected.
Age: 5.0
Sex: M
Vaccine: UNK, UNK, UNK, UNK, UNK
Symptoms: Contusion, Local swelling
Clinical narrative: STARTED WITH BRUISING AND HUGE BASEBALL SIZED SWELLING OF HIS ARM.
Age: 18.0
Sex: M
Vaccine: MENB
Symptoms: Pruritus, Rash, Rash pruritic
Clinical narrative: Got BEXSERO in left arm on Tuesday 1/24/2017  Neck was a little itchy that night and then Wednesday am woke up and had rash on back of neck, chin, and arms that was itchy.  Did take Benadryl starting last night (1/26/2017) and took at 9pm, 2am, 6am today (1/27/2017) and this has helped some.
Age: 0.42
Sex: F
Vaccine: UNK
Symptoms: Abnormal behaviour, Autism spectrum disorder, Decreased eye contact, Immediate post-injection reaction, Pain
Clinical narrative: I can not remember the exact date of her last round of shots.  She immediately stopped saying mama, dada, baba - stopped eye contact, smiling and laughing -started throwing horrible fits and pulling hair and ears constantly screaming in pain. It was like the flip of a switch from my happy smiling baby to this. She now shows signs of ASD.
Age: 0.42
Sex: F
Vaccine: UNK
Symptoms: Regressive behaviour, Screaming
Clinical narrative: I can not remember the exact date of her last round of shots.  She immediately stopped saying mama, dada, baba - stopped eye contact, smiling and laughing -started throwing horrible fits and pulling hair and ears constantly screaming in pain. It was like the flip of a switch from my happy smiling baby to this. She now shows signs of ASD.
Age: 77.0
Sex: F
Vaccine: PNC13
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Pain
Clinical narrative: Swollen and red at the site of the injection. Erythema and slight induration over lateral deltoid; Marked margins, warm to the touch, no break in the skin. Pain rated as 7/10 when arm is moved. Movement make pain worse.
Age: 77.0
Sex: F
Vaccine: PNC13
Symptoms: Pain in extremity
Clinical narrative: Swollen and red at the site of the injection. Erythema and slight induration over lateral deltoid; Marked margins, warm to the touch, no break in the skin. Pain rated as 7/10 when arm is moved. Movement make pain worse.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Erythema and swelling at injection site, no itching reported.
Age: 1.25
Sex: F
Vaccine: MMR
Symptoms: Pyrexia, Rash generalised, Vomiting
Clinical narrative: Vomiting, full body rash, fevers as high as 105.
Age: 26.0
Sex: F
Vaccine: FLUC4, TDAP
Symptoms: Diarrhoea, Vomiting
Clinical narrative: PATIENT STATES SHE WAS VOMITING AND SEVERE DIARRHEA.
Age: 11.0
Sex: F
Vaccine: MEN, TDAP
Symptoms: Cellulitis, Peripheral swelling, Skin warm
Clinical narrative: PATIENT DEVELOPED SWELLING ON BOTH ARMS MORE SO ON THE LEFT ARM HOT TO THE TOUCH A BIT OF CELLULITIS GIVEN ATARAX 10 MG ADVISED TO APPLY COLD COMPRESSES.
Age: 70.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Peripheral swelling, Skin warm
Clinical narrative: Upper arm red, swollen, warm to touch.
Age: 12.0
Sex: M
Vaccine: HPV9, HPV9
Symptoms: Activities of daily living impaired, Fatigue, Vaccination site nodule
Clinical narrative: Felt tired and stayed home from school on 12/13/16. On that day they noticed a knot in his arm where the vaccine was given. Followed up in my office 1/10/17 for the knot that was still there. Told them to massage the area and move the arm around more. No redness at the injection site.
Age: 12.0
Sex: M
Vaccine: HPV9, HPV9
Symptoms: Fatigue, Loss of personal independence in daily activities, Vaccination site nodule
Clinical narrative: Felt tired and stayed home from school on 12/13/16. On that day they noticed a knot in his arm where the vaccine was given. Followed up in my office 1/10/17 for the knot that was still there. Told them to massage the area and move the arm around more. No redness at the injection site.
Age: 23.0
Sex: F
Vaccine: FLUX, FLUX
Symptoms: Asthenia, Chills, Dyspnoea, Fatigue
Clinical narrative: At first it began with extreme fatigue, chills, and weakness. Then later it became impossible to take deep breaths and could hyperventilate.
Age: 66.0
Sex: F
Vaccine: VARZOS
Symptoms: Facial pain, Hypoaesthesia, Pain, Paraesthesia, Skin discolouration
Clinical narrative: I thought I had a blemish on the left side of my face. But it started hurting very badly. I put my finger on it and pushed to help relieve the pain. And then there was a shooting pain/shock sensation from it to my cheek. Then the left side of my face went numb, plus had tingling, and some shooting pain. This has now been going on 24/7 since.
Age: 18.0
Sex: F
Vaccine: MENB, MNQ
Symptoms: Asthenia, Crying, Dizziness, Feeling cold, Headache
Clinical narrative: Felt very weak, Dizzy, Bad head ache, feeling cold, shaking, crying, went to acute care and was told to take Benadryl and Tylenol and check for fever or difficulty breathing.
Age: 18.0
Sex: F
Vaccine: MENB, MNQ
Symptoms: Tremor
Clinical narrative: Felt very weak, Dizzy, Bad head ache, feeling cold, shaking, crying, went to acute care and was told to take Benadryl and Tylenol and check for fever or difficulty breathing.
Age: 17.0
Sex: F
Vaccine: HEPA, HPVX, HEPA, HPV9
Symptoms: Dizziness, Musculoskeletal stiffness, Neurological examination normal, Posture abnormal, Seizure
Clinical narrative: Head went forward..eyes closed. Body stiffened. Seizure lasted about 30 seconds. Patient felt lightheaded after but was able to walk out of Health Department after resting for 10 minutes or so.
Age: 17.0
Sex: F
Vaccine: HEPA, HPVX, HEPA, HPV9
Symptoms: Dizziness, Dyskinesia, Fatigue, Immediate post-injection reaction, Pallor
Clinical narrative: Head went forward..eyes closed. Body stiffened. Seizure lasted about 30 seconds. Patient felt lightheaded after but was able to walk out of Health Department after resting for 10 minutes or so.
Age: 2.0
Sex: M
Vaccine: VARCEL
Symptoms: Asthenia, Eye discharge, Pyrexia
Clinical narrative: High fever for 2 days, low energy, running eyes.
Age: 2.0
Sex: M
Vaccine: MMR
Symptoms: Eye discharge, Pharyngeal oedema, Pyrexia, Rhinorrhoea
Clinical narrative: High fever for 2 days, then better for 1 day, then high fever for 2 more days. running nose, swollen throat, running eyes for about a week.
Age: 45.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site mass, Injection site pain
Clinical narrative: Soreness in shoulder and upper left quadrant still feels lump in arm feels "hot" inside but not to touch.
Age: 61.0
Sex: M
Vaccine: FLUX, FLUX
Symptoms: Uveitis
Clinical narrative: Uveitis possibly related to zoster vaccine. Prolonged course with treatment involving acyclovir, glaucoma drops, and topical steroids over the last 12 months. Now under control.
Age: 65.0
Sex: M
Vaccine: FLU3
Symptoms: Chills, Pain
Clinical narrative: Approximately 5 hours after receiving the vaccine pt. experienced severe body aches and chills. He took ibuprofen, covered with a blanket and went to bed. He woke up the next morning feeling fine.
Age: 23.0
Sex: F
Vaccine: FLU3
Symptoms: Cellulitis, Contusion, Erythema, Mobility decreased, Pain in extremity
Clinical narrative: 2 days after vaccine was given, patient went to emergency room because arm was red, swollen, hurt, and couldn't move it. Doctors said she had cellulitis and gave her a weeks supply of antibiotics. One week later antibiotics finished and arm looks like there is a bruise.
Age: 23.0
Sex: F
Vaccine: FLU3
Symptoms: Peripheral swelling
Clinical narrative: 2 days after vaccine was given, patient went to emergency room because arm was red, swollen, hurt, and couldn't move it. Doctors said she had cellulitis and gave her a weeks supply of antibiotics. One week later antibiotics finished and arm looks like there is a bruise.
Age: 2.0
Sex: M
Vaccine: FLU4, HEP, IPV
Symptoms: Expired product administered, No adverse event
Clinical narrative: Nothing adverse happened to patient. However, office said patient was due for 2nd polio and 2nd Hep B, so I gave them. Come to find but an email was sent out this morning from DHS contractor and an issue was identified in agency with the assessment of Hep A, Hep B, polio and HPV. The email was sent to the clerk, I was in clinic. Also the polio given had expired 1-14-17.
Age: 1.92
Sex: M
Vaccine: FLU4, HEP, HEPA, IPV
Symptoms: No adverse event
Clinical narrative: Nothing adverse happened to patient. However, registry said patient was due for 2nd polio, 2nd Hep B, so I gave them. Come to find out an email was sent out this morning from contractor and an issue was identified in registry with the assessment of Hep A, Hep B, Polio and HPV. The email was sent to the Imms clerk.
Age: 68.0
Sex: F
Vaccine: PNC13
Symptoms: Headache, Injection site pain, Memory impairment
Clinical narrative: Pain at injection site and under arm. Head pain, forgetful.
Age: 11.0
Sex: F
Vaccine: HPV9, MNQ, TDAP, HPV9, MNQ, TDAP
Symptoms: Syncope, Tremor
Clinical narrative: Fainted 5 sec, shaking 3 min.
Age: 76.0
Sex: F
Vaccine: PNC13
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Pruritus
Clinical narrative: Patient noticed itching and finally look at injection side and reports erythema and swelling, induration 12 x 7.5 cm and itching.
Sex: U
Vaccine: DTAP, DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Crying, Diarrhoea, Fatigue, Flatulence, Gastrointestinal sounds abnormal
Clinical narrative: Fussiness. Explosive diarrhea.  Baby very fatigued. Gas pains, irritability aggressive crying not easily consoled.
Sex: U
Vaccine: DTAP, DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Irritability
Clinical narrative: Fussiness. Explosive diarrhea.  Baby very fatigued. Gas pains, irritability aggressive crying not easily consoled.
Age: 0.08
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV5
Symptoms: Faeces discoloured, Full blood count normal, Irritability, Occult blood negative, Pyrexia
Clinical narrative: 2 month vaccines (PEDIARIX Hib, PCV-13, ROTATEQ) given 1-23-17. On 1-25-17 mom reports infant had a "meconium looking dark stool: x1. Fussy and low grade fever. Seen in office on 1-26-17. Normal stool Guaiac negative.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema
Clinical narrative: (l) deltoid redness given RX AUGMENTIN, Hydrocortisone cream.
Age: 1.17
Sex: F
Vaccine: HEP, IPV, MMR, VARCEL
Symptoms: Extra dose administered
Clinical narrative: Administered 2 vaccines that were not necessary for recommended dosing schedule. Hep B vaccine administered as well as IPV. MCIR listed recommended dosing that was not correct and pt. had 2 imm. records in MCIR that have since been merged, or in process of being merged.
Age: 72.0
Sex: F
Vaccine: FLU4, PPV
Symptoms: Dyspnoea, Nausea, Rash, Rash erythematous
Clinical narrative: 10 cm x 10 cm rash on (R) deltoid. Erythematous bilateral check rash. Nausea. SOB.
Age: 17.0
Sex: F
Vaccine: HPV2
Symptoms: Alopecia, Anxiety, Arthralgia, Blood test, Depression
Clinical narrative: Within a few weeks of vaccination patient complained of hip pain. Went to orthopedic - did x-rays -showed nothing. He recommended physical therapy - 14 sessions later pain traveled to knees - MRI next -showed nothing. Chronic joint pain, fatigue, sleeplessness, hair loss, anxiety, panic attacks, depression, dizziness, fainting.
Age: 17.0
Sex: F
Vaccine: HPV2
Symptoms: Dizziness, Fatigue, Insomnia, Laboratory test, Nuclear magnetic resonance imaging normal
Clinical narrative: Within a few weeks of vaccination patient complained of hip pain. Went to orthopedic - did x-rays -showed nothing. He recommended physical therapy - 14 sessions later pain traveled to knees - MRI next -showed nothing. Chronic joint pain, fatigue, sleeplessness, hair loss, anxiety, panic attacks, depression, dizziness, fainting.
Age: 17.0
Sex: F
Vaccine: HPV2
Symptoms: Panic attack, Syncope, X-ray normal
Clinical narrative: Within a few weeks of vaccination patient complained of hip pain. Went to orthopedic - did x-rays -showed nothing. He recommended physical therapy - 14 sessions later pain traveled to knees - MRI next -showed nothing. Chronic joint pain, fatigue, sleeplessness, hair loss, anxiety, panic attacks, depression, dizziness, fainting.
Age: 1.25
Sex: M
Vaccine: HIBV, MMR
Symptoms: Electroencephalogram normal, Febrile convulsion, Lumbar puncture normal, Pyrexia, Seizure like phenomena
Clinical narrative: Four days following vaccines he had a fever and a complex febrile seizure with seizure-like behavior greater than 15 minutes. He also had nasal congestion and cough at the time. He has fully recovered. In the ER he was given diazepam x 3 doses.
Age: 20.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Patient was given VARIVAX on 1-24-2017. She reported redness, mild swelling, and pain at injection site on 1-26. I contacted CDC for advice and told pt. to use ice cold compress, anti-inflammatory, and antipruritic as instructed by CDC. I told patient to contact primary care MD or proceed to ER if worsens. I have been following up with patient.
Age: 0.75
Sex: M
Vaccine: HEPA
Symptoms: Drug administered to patient of inappropriate age
Clinical narrative: Hep A administered at 9m of age. Protocol is to start series at 1 yr.
Age: 1.25
Sex: M
Vaccine: DTAP, HEPA, HIBV
Symptoms: Erythema multiforme, Laboratory test, Pyrexia, Rash
Clinical narrative: 3-4 hours after vaccine patient broke out in a rash and a fever of 103. Went to Urgent Care and Tx with Antihistamine. Seen by Dr. 1/26/17. Dx Erythema Multiforme.
Sex: F
Vaccine: FLUX, PPV
Symptoms: Arthralgia
Clinical narrative: Case number PHHY2015US156680, is an initial spontaneous report received from the Vaccine Adverse Event Reporting System (VAERS reference number: 594366) website on 02 Nov 2015. This report refers to a female patient of unknown gender. Past medical history was not reported. Concomitant medications included SYSTANE. The patient was vaccinated with seasonal influenza vaccine (manufacturer unknown and batch number: not reported) and pneumococcal vaccine (manufacturer unknown and batch number: not reported) on an unknown date. After vaccination, the patient experienced arthritis type pain. The outcome of the event was unknown. The seriousness of the event was reported as non serious and causality of the event was not reported.
Sex: F
Vaccine: FLUX
Symptoms: Lip swelling
Clinical narrative: Case number PHHY2015US157126 is an initial spontaneous report received from the Vaccine Adverse Event Reporting System (VAERS reference number: 600795) website on 24 Nov 2015. This report refers to a female patient of an unknown age. Medical history and concomitant medications were not reported. The patient was vaccinated with seasonal influenza vaccine (manufacturer and batch number: not reported) in 2009. Post vaccination the patient experienced lip swelling. Outcome of the event was recovered. The reporter assessed the event as non-serious. Causality of the event was unknown. Further the patient was vaccinated with Flu nasal mist (manufacturer and batch number: not reported) and seasonal influenza vaccine (manufacturer and batch number: not reported) in 2010 and 2012 respectively and experienced lip swelling after each time after vaccination (see case: PHHY2015US157129).
Age: 7.0
Sex: F
Vaccine: FLUX
Symptoms: Urticaria
Clinical narrative: Case number PHHY2015US172889, is an initial spontaneous report received from the Vaccine Adverse Event Reporting System (VAERS reference number: 607110): on 29 Dec 2015. This report refers to a 07 years old female patient. Historical condition included deaf left ear, current condition included: stomach ache. Concomitant medication was not reported, The patient was vaccinated with seasonal influenza vaccine (manufacture unknown, batch number not reported) into left arm on 29 Oct 2015. On 30 Oct 2015, the patient was broke out in hives at school. The patient was sent to home. They called the physician and was told to give her BENADRYL. The outcome of the event was complete recovery on an unknown date. The seriousness of the event reported as non serious and causality was not reported.
Age: 44.0
Sex: F
Vaccine: FLU3
Symptoms: Abdominal pain, Cholecystectomy, Cholecystitis
Clinical narrative: Intense abdominal pain.
Age: 27.0
Sex: F
Vaccine: HPVX
Symptoms: Dizziness, Fatigue, Hypersomnia, Injection site pain
Clinical narrative: Sudden onset mild lightheadedness with mild dizziness, moderate tiredness (NB: patient works an overnight shift regularly. Had slept for approximately 11 hours straight prior to onset of symptoms. Symptoms appeared within 2.5 hours of waking). Continued mild pain at injection site. Patient laid down again and ultimately slept a further three hours.
Age: 44.0
Sex: M
Vaccine: PPV
Symptoms: Limb injury, Vaccination complication
Clinical narrative: Shoulder related to vaccine injury; right.
Age: 33.0
Sex: F
Vaccine: FLU4
Symptoms: Antinuclear antibody negative, Arthralgia, Blood thyroid stimulating hormone normal, Chest X-ray normal, Chlamydia test negative
Clinical narrative: Swelling lumps over right clavicle progressing to ongoing shoulder girdle syndrome, collarbone pain, migrating arthralgia, waxing and waning pea sized lumps over clavicles bilaterally. Sudden onset of gluten intolerance.
Age: 33.0
Sex: F
Vaccine: FLU4
Symptoms: Full blood count normal, Gluten sensitivity, HIV test negative, Hepatitis C test negative, Laboratory test normal
Clinical narrative: Swelling lumps over right clavicle progressing to ongoing shoulder girdle syndrome, collarbone pain, migrating arthralgia, waxing and waning pea sized lumps over clavicles bilaterally. Sudden onset of gluten intolerance.
Age: 33.0
Sex: F
Vaccine: FLU4
Symptoms: Liver function test normal, Mass, Neuralgic amyotrophy, Pain, Red blood cell sedimentation rate increased
Clinical narrative: Swelling lumps over right clavicle progressing to ongoing shoulder girdle syndrome, collarbone pain, migrating arthralgia, waxing and waning pea sized lumps over clavicles bilaterally. Sudden onset of gluten intolerance.
Age: 33.0
Sex: F
Vaccine: FLU4
Symptoms: Swelling, Treponema test negative
Clinical narrative: Swelling lumps over right clavicle progressing to ongoing shoulder girdle syndrome, collarbone pain, migrating arthralgia, waxing and waning pea sized lumps over clavicles bilaterally. Sudden onset of gluten intolerance.
Age: 25.0
Sex: M
Vaccine: MMR
Symptoms: Blood glucose, Glycosylated haemoglobin, Type 2 diabetes mellitus
Clinical narrative: Developed severe type II diabetes within 6 weeks of MMR vaccine.
Age: 4.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site inflammation, Injection site oedema, Injection site swelling, Injection site warmth, Pyrexia
Clinical narrative: Intense inflammation including turgescence, heat, and edema spreading to entire thigh, surrounding administration site, over 48 hour period. Low grade fever.
Age: 53.0
Sex: F
Vaccine: FLU4
Symptoms: Erythema, Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
Clinical narrative: Warm, redness, sore injection site then over the course of 5 days worsening redness and spreading from deltoid to 70% of bicep just past elbow, with hardness in middle. Used cold compresses & ADVIL. After 5 days worsening, started to get better, redness area shrinking, now gone after 9 days.
Age: 0.17
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV5
Symptoms: Intussusception, Ultrasound abdomen abnormal
Clinical narrative: Intussusception.
Age: 37.0
Sex: F
Vaccine: ANTH, IPV, TYP
Symptoms: Rash
Clinical narrative: Rash deltoid. Rash is not itchy and not swollen.
Age: 70.0
Sex: F
Vaccine: FLU3
Symptoms: Dizziness, Injection site pain
Clinical narrative: Severe Dizziness with injection site pain. No other symptoms. Resolved in 2 days. As reported by patient.
Age: 44.0
Sex: M
Vaccine: PPV, PPV
Symptoms: Bronchial hyperreactivity, Chest discomfort, Cough, Erythema, Feeling hot
Clinical narrative: Chest tightness with wheezing, reactive airway, fever (up to 102), localized swelling, localized heat, localized redness, pain in the shoulder, minimal cough.
Age: 44.0
Sex: M
Vaccine: PPV, PPV
Symptoms: Local swelling, Musculoskeletal pain, Pyrexia, Wheezing
Clinical narrative: Chest tightness with wheezing, reactive airway, fever (up to 102), localized swelling, localized heat, localized redness, pain in the shoulder, minimal cough.
Age: 44.0
Sex: M
Vaccine: PPV, PPV
Symptoms: Chest discomfort, Cough, Dyspnoea, Injection site pain, Injection site warmth
Clinical narrative: Chest tightness with wheezing, reactive airway, fever (up to 102), localized swelling, localized heat, localized redness, pain in the shoulder, minimal cough.
Age: 44.0
Sex: M
Vaccine: PPV, PPV
Symptoms: Pain, Pyrexia, Secretion discharge, Wheezing
Clinical narrative: Chest tightness with wheezing, reactive airway, fever (up to 102), localized swelling, localized heat, localized redness, pain in the shoulder, minimal cough.
Age: 0.33
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Electroencephalogram abnormal, Gene mutation, Gene mutation identification test positive, Nuclear magnetic resonance imaging normal, Partial seizures
Clinical narrative: Staring spells with following focal epilepsy, SCN8A (the cute syndrome) Gene Mutation. Taking KEPPRA (4.6 ml per day) and Phenobarbital (10 ml per day).
Age: 0.33
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Staring
Clinical narrative: Staring spells with following focal epilepsy, SCN8A (the cute syndrome) Gene Mutation. Taking KEPPRA (4.6 ml per day) and Phenobarbital (10 ml per day).
Age: 75.0
Sex: F
Vaccine: FLU3
Symptoms: Audiogram, Balance disorder, Nuclear magnetic resonance imaging, Walking aid user
Clinical narrative: I woke up that morning and my sense of balance was terrible. For about 3 months, I had to hold on to walls and furniture to get around the house. Leaving the house was most difficult, and eventually I had to use a cane.
Age: 54.0
Sex: M
Vaccine: FLU3
Symptoms: Guillain-Barre syndrome
Clinical narrative: Patient states he was seen by physician for symptoms after the immunization and physician stated he had a non-traditional case of Guillain-Barre syndrome.
Age: 4.0
Sex: M
Vaccine: DTAP
Symptoms: Erythema, Mass, Swelling, Tenderness
Clinical narrative: Redness, swelling, sensitive, raised lump under the skin. I marked with a pen, and it spread more over night.
Age: 0.33
Sex: M
Vaccine: DTAP
Symptoms: Rash, Urticaria
Clinical narrative: Urticaria starting on the face -spread to the rest of the body-no other symptoms  No itching.  Lasting 3 days-seen today still with rash-waxes and wanes.
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Decreased appetite, Feeling abnormal, Fluid intake reduced, Influenza virus test negative, Lymphadenopathy
Clinical narrative: High Fever 102 - 104 ( Jan 23-26, 2017 ) Rashes (01-25-17) Fuzziness Lack of appetite, refusing to drink milk/fluids Swollen lymph nodes.
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Pyrexia, Rash, Streptococcus test negative
Clinical narrative: High Fever 102 - 104 ( Jan 23-26, 2017 ) Rashes (01-25-17) Fuzziness Lack of appetite, refusing to drink milk/fluids Swollen lymph nodes.
Age: 58.0
Sex: F
Vaccine: FLUX, FLU4, FLUX
Symptoms: Burning sensation, Injection site hypersensitivity, Injection site pain, Paraesthesia
Clinical narrative: Pins and Needles/ sunburn feeling in shoulder and upper arm. Tender area where shot was given. Skin is hypersensitive flu shot given.
Age: 58.0
Sex: F
Vaccine: FLUX, FLU4, FLUX
Symptoms: Hyperaesthesia, Injection site reaction
Clinical narrative: Pins and Needles/ sunburn feeling in shoulder and upper arm. Tender area where shot was given. Skin is hypersensitive flu shot given.
Age: 58.0
Sex: F
Vaccine: FLUX, FLU4, FLUX
Symptoms: Burning sensation, Hyperaesthesia, Injection site pain, Injection site reaction, Paraesthesia
Clinical narrative: Pins and Needles/ sunburn feeling in shoulder and upper arm. Tender area where shot was given. Skin is hypersensitive flu shot given.
Age: 77.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth
Clinical narrative: The patient developed an injection site reaction that occurred later after the shot (approximately 6 hours). It included erythema moderate swelling and warmth and tenderness.
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMRV
Symptoms: Injection site erythema, Injection site mass, Injection site warmth
Clinical narrative: Redness and lump on left arm a little warmth. Patient denies pain. Reaction just started yesterday.
Age: 70.0
Sex: M
Vaccine: PPV
Symptoms: Asthenia, Chills, Fatigue, Pain, Pyrexia
Clinical narrative: Fever of 2 degrees over normal, chills,aches, fatauge, weakness.
Age: 32.0
Sex: F
Vaccine: TDAP
Symptoms: Abdominal distension, Nausea, Pain, Vomiting
Clinical narrative: Painful bloating, vomiting, nausea.
Age: 35.0
Sex: F
Vaccine: HEP
Symptoms: Pain in extremity, Pyrexia
Clinical narrative: Fever, arm pain.
Age: 74.0
Sex: F
Vaccine: PPV
Symptoms: Mental disorder, Pain in extremity, Syncope
Clinical narrative: Patient went to the ER due to several fainting and arm hurting.  ER Doctor examined her and did not find anything.
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Recurring rash on face and neck.
Age: 61.0
Sex: M
Vaccine: FLU4, VARZOS, FLUX, VARZOS, FLU4, VARZOS
Symptoms: Facial paralysis, Hypoaesthesia, Lumbar puncture, Nuclear magnetic resonance imaging brain, Nuclear magnetic resonance imaging spinal
Clinical narrative: Entire face felt like it was shot with NOVOCAINE, Bell's Palsy presented the following day.
Age: 61.0
Sex: M
Vaccine: FLU4, VARZOS, FLUX, VARZOS, FLU4, VARZOS
Symptoms: Facial paralysis, Hypoaesthesia, Lumbar puncture, Nuclear magnetic resonance imaging
Clinical narrative: Entire face felt like it was shot with NOVOCAINE, Bell's Palsy presented the following day.
Age: 61.0
Sex: M
Vaccine: FLU4, VARZOS, FLUX, VARZOS, FLU4, VARZOS
Symptoms: Facial paralysis
Clinical narrative: Entire face felt like it was shot with NOVOCAINE, Bell's Palsy presented the following day.
Age: 50.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site pain, Mobility decreased
Clinical narrative: Patient having pain at injection site as well as difficulty lifting up her arm.
Age: 0.33
Sex: F
Vaccine: DTAP, HIBV, IPV, PPV, RVX
Symptoms: Diet refusal, Differential white blood cell count, Enema administration, Full blood count, Haematochezia
Clinical narrative: She started off getting very fussy during feedings and was very sleepy (approx. 10:00 am). Within 8-10 hours she began vomiting every 45 minutes, refused all bottles, and was extremely lethargic. We called the emergency pediatrics line and they advised we watch her closely and try giving her Pedialyte if she would tolerate it. By approximately 11:30 pm, she had jelly-like blood in her stool. At that time we took her to the children's emergency room where they diagnosed her with intussusception. They were able to release the blockage with an air enema.
Age: 0.33
Sex: F
Vaccine: DTAP, HIBV, IPV, PPV, RVX
Symptoms: Intussusception, Irritability, Lethargy, Metabolic function test, Platelet count
Clinical narrative: She started off getting very fussy during feedings and was very sleepy (approx. 10:00 am). Within 8-10 hours she began vomiting every 45 minutes, refused all bottles, and was extremely lethargic. We called the emergency pediatrics line and they advised we watch her closely and try giving her Pedialyte if she would tolerate it. By approximately 11:30 pm, she had jelly-like blood in her stool. At that time we took her to the children's emergency room where they diagnosed her with intussusception. They were able to release the blockage with an air enema.
Age: 0.33
Sex: F
Vaccine: DTAP, HIBV, IPV, PPV, RVX
Symptoms: Somnolence, Ultrasound abdomen, Vomiting, X-ray
Clinical narrative: She started off getting very fussy during feedings and was very sleepy (approx. 10:00 am). Within 8-10 hours she began vomiting every 45 minutes, refused all bottles, and was extremely lethargic. We called the emergency pediatrics line and they advised we watch her closely and try giving her Pedialyte if she would tolerate it. By approximately 11:30 pm, she had jelly-like blood in her stool. At that time we took her to the children's emergency room where they diagnosed her with intussusception. They were able to release the blockage with an air enema.
Age: 66.0
Sex: M
Vaccine: VARZOS
Symptoms: Headache, Injection site pain, Injection site swelling, Mass
Clinical narrative: Swelling and soreness in fatty tissue of arm when injected.  'Lump' still sore as of 01/29/17 13:06 PM.  Headache all day of 01/28/2017 but appears gone as of 01/29/2017, 13:06 PM.
Age: 25.0
Sex: F
Vaccine: HPV4
Symptoms: Autoimmune disorder, Craniocerebral injury, Encephalitis, Guillain-Barre syndrome, Hormone level abnormal
Clinical narrative: Encephalitis. Vasculitis. Autoimmune dysfunction. Guillain Barre type syndrome. Intractable pain syndrome.  Full body burning pain.  Ovarian cysts. Hormonal abnormalities. Traumatic brain.  All caused by HPV.
Age: 25.0
Sex: F
Vaccine: HPV4
Symptoms: Ovarian cyst, Pain, Vasculitis
Clinical narrative: Encephalitis. Vasculitis. Autoimmune dysfunction. Guillain Barre type syndrome. Intractable pain syndrome.  Full body burning pain.  Ovarian cysts. Hormonal abnormalities. Traumatic brain.  All caused by HPV.
Age: 57.0
Sex: M
Vaccine: VARZOS
Symptoms: Erythema
Clinical narrative: Pt wife called (I dont remember if it was that night or the following night)and said he had some redness. When I saw her again 1/29/17 I asked what happened. She said it continued to get red so they went to a Dr. and were told he may have cellulitis. He was given Bactrim and is better now.
Age: 54.0
Sex: F
Vaccine: FLU4, PPV
Symptoms: Blister, Cellulitis, Erythema, Injected limb mobility decreased, Injection site swelling
Clinical narrative: Swelling of at injection site, up to shoulder to base of neck and down to elbow. Skin was red, hot and blistery. Patient had severe, intense pain and limitation from swelling.