chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Acute disseminated encephalomyelitis, Asthenia, Balance disorder, Coordination abnormal, Decreased appetite
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Fatigue, Headache, Incontinence, Intensive care, Mental status changes
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Movement disorder, Neck pain, Pain in extremity, Pyrexia, Speech disorder
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Acute disseminated encephalomyelitis, Antibody test negative, Antinuclear antibody negative, Ataxia, Blood creatine phosphokinase decreased
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Body temperature increased, Borrelia burgdorferi serology negative, C-reactive protein increased, CSF cell count increased, CSF culture negative
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: CSF glucose normal, CSF myelin basic protein increased, CSF protein normal, CSF white blood cell count increased, Cryptococcus antigen
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Dysarthria, Enterovirus serology test negative, Epstein-Barr virus test negative, Fatigue, Gait disturbance
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Gram stain negative, HIV test negative, Headache, Herpes simplex serology negative, Hypersomnia
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Intensive care, Irritability, Lethargy, Mononucleosis heterophile test negative, Muscular weakness
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Nuclear magnetic resonance imaging abnormal, Pain in extremity, Polymerase chain reaction, Red blood cell sedimentation rate increased, Red blood cells CSF positive
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP, MNQ, TDAP
Symptoms: Somnolence, Urinary incontinence, Weight bearing difficulty, West Nile virus test negative
Clinical narrative: The patient is a 14-year-old male who presented on 8/19/09 to Emergency Department, and was subsequently transferred to another Hospital, for evaluation of lethargy, somnolence, and ataxia. As per the patient's mother, the patient went on a camping trip from 8/6-12/09. He came home and on 8/14 started complaining of his legs hurting and also of headache. He was noted to be more fatigued, sleeping more, with a temperature of 101F. On 8/18/09, he was seen by his primary care doctor, a strep test was done and blood cultures were sent. He was told it was of viral etiology and sent home. The day before admission, he become more lethargic with increasing irritability and decreasing ability to bear weight on his lower extremities, with difficulty walking, slurred speech, and incontinence of urine. During this time, the patient did not have any nausea, vomiting, diarrhea. There were no rashes, nor recollections of tick bites. The patient was admitted to the PICU where he was started on vancomycin, ceftriaxone, and acyclovir, with the addition of Tamiflu for possible viral etiology. The patient continued to be weak during the PICU stay, with small improvements each day, being able to move his extremities slightly more. The patient remained in the PICU for 3 days, during which he received an MRI of the brain and spinal cord which showed prominent multifocal, nonspecific, T2 hyperintense signal abnormalities throughout the bilateral deep and periventricular white matter, cortical and deep gray matter, thalamic nuclei, mid brain, and pons as well as along the cervicothoracic spinal cord suspicious for infectius or inflammatory encephalomyelitis consistent with acute disseminated encephalomyelitis (ADEM). After 3 days in the PICU the patent was transferred to the general floor after having started Solumedrol 500mg BID for a total of 5 days per recommendation of the neurology service. While on the floor, the patient's strength continued to improve, with upper and lower extremity weakness becoming less and less, but still with mild hip flexor weakness upon discharge on 8/26/09. 10/19/09 Discharge summary and hospital records received for dates: 8/20/09 to 8/26/09.  DC DX: ADEM. Presenting symptoms upon admission: pain in legs, HA, diffused muscle pain, lower back pain, fatigue, slurred speech, incontinence of urine. Pt received vax 8/4/08 with no prior illness until symptoms began 8/18/09. Assessment findings in ER: lethargic, diaphoretic, appears sickly. Prelim DX: acute meningitis vs encephalitis vs enlargement of arachnoid cyst vs viral syndrome. Admitting Assessment: sluggish speech, ataxic gait, no rash, no bites. Diagnostics ordered. Pt. tx Iv therapy and DC with improved condition status but with continued lower extremity weakness.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Hypersensitivity, Injection site erythema
Clinical narrative: Allergic Reaction, left arm turned red. That same day in the evening was prescribed Tylenol for pain and to apply cold compress.
Age: 68.0
Sex: M
Vaccine: VARZOS
Symptoms: Blister, Herpes zoster, Musculoskeletal pain, Pain, Pain in extremity
Clinical narrative: Pain in the left shoulder and arm 8-19-09 - Blister on middle finger and palm of left hand 8-22-09 - Blisters on palm left hand - painful 8-24-09 - also rash on left arm. Many blisters on left hand-rash worse- very painful 8-27-09 - hands tremble. OR 8-16-09 shake.
Age: 68.0
Sex: M
Vaccine: VARZOS
Symptoms: Rash, Tremor
Clinical narrative: Pain in the left shoulder and arm 8-19-09 - Blister on middle finger and palm of left hand 8-22-09 - Blisters on palm left hand - painful 8-24-09 - also rash on left arm. Many blisters on left hand-rash worse- very painful 8-27-09 - hands tremble. OR 8-16-09 shake.
Age: 68.0
Sex: F
Vaccine: FLU3
Symptoms: Urticaria
Clinical narrative: Pt broke out in hives on arms, neck, chest, and abdomen.  Pt reported to PCP who prescribed a MEDROL dose pack & topical BENADRYL.
Age: 11.0
Sex: F
Vaccine: HEPA, HPV4, MNQ
Symptoms: Drug hypersensitivity, Pyrexia, Rash erythematous, Rash pruritic, Swelling
Clinical narrative: Child woke today with low grade fever 100 degrees and red/raised rash on her truck (back, shoulder blades, abd).  Rash is itchy.  Mom treating with TYLENOL, BENADRYL and Oatmeal Bath.  Hx of allergy to PENICILLIN - BACTRIN.
Age: 42.0
Sex: F
Vaccine: TDAP
Symptoms: Pain in extremity
Clinical narrative: Complained of soreness L arm with touch and movement. Has persisted x 2 weeks lasted longer than expected.
Age: 1.1
Sex: F
Vaccine: FLU3, HIBV
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash
Clinical narrative: 5X3 cm Erythema, very itchy, red and raised around injection. Lesion continued to increase in size. Rechecked 24 hour later, put on KEFLEX. 2 days later not hot, not swollen, decreased size, only slight.
Age: 62.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Oedema peripheral, Skin warm
Clinical narrative: Swelling, redness, and warmth in arm several hours after receiving PNEUMOVAX.  BENADRYL was given to the patient.
Age: 68.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Diarrhoea, Hypoaesthesia, Myalgia, Nausea
Clinical narrative: Flu vaccine given @ 0922 AM.  Onset of chills (shaking) followed by fever to 102 degrees.  C/O nausea, diarrhea and muscle aches.  Also c/o fingers on left hand were numb feeling.  Took OTC antacid for stomach upset.  Symptoms resolved by 0800 on 9-16-09.
Age: 68.0
Sex: F
Vaccine: FLU3
Symptoms: Pyrexia, Tremor
Clinical narrative: Flu vaccine given @ 0922 AM.  Onset of chills (shaking) followed by fever to 102 degrees.  C/O nausea, diarrhea and muscle aches.  Also c/o fingers on left hand were numb feeling.  Took OTC antacid for stomach upset.  Symptoms resolved by 0800 on 9-16-09.
Age: 56.0
Sex: F
Vaccine: FLU3
Symptoms: Face oedema
Clinical narrative: Patient received self limiting left sided facial edema, with no shortness of breath, rash, LOC, etc. The reaction occurred several hours after administration, but did not require medical attention.
Age: 4.0
Sex: M
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Injection site pruritus, Rash erythematous
Clinical narrative: Red raised sandpaper appearance to rash. Itch to site of KINRIX (DTAP/IVP) right deltoid.
Age: 79.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site haematoma, Injection site induration, Injection site swelling
Clinical narrative: Pt reported arm swelling and "bruise" where she received influenza vaccination (at 3:58 PM 9/16/09).  Firm swelling 1" diameter) surrounding arm site that is affected.  (Approx 12". below site arm diameter is 11").  Hematoma present @ injection site 1" in diameter.  Able to move arm.  Returned 24 hours later 9/17.  No change in condition.  Ecchymotic changes present with Hematoma.  Referred to Primary Care MD.  Pt refused.  She consulted with her son who is a DPM.  No treatment required.
Age: 65.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Induration, Inflammation, Pain, Paraesthesia, Rash
Clinical narrative: Pt given PNEUMOVAX & FLUVIRUI in same arm at same time b/c pt s/p mastectomy and no lymph nodes in right arm.  Pt experienced 3" X 3" in flamed rash which was very painful and feels "hard" to the touch.  Tingling radiates down left arm to fingers, comes and goes with position.
Age: 76.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Cellulitis, Injection site erythema, Injection site swelling
Clinical narrative: Following injection, patient reported redness and swelling of arm around injection site.  Throughout day, worsened and pt went to emergency room where she was treated for cellulitis.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5, DTAPIPVHIB, PNC, RVX
Symptoms: Body temperature increased, Crying, Dehydration, Full blood count, Irritability
Clinical narrative: Received vaccines 8/31/09. Fever 101 9/3/09. Fussy, cranky, poor eye contact. 9/4/09 listless, T 103+, lethargic, bad rash (mac. pap. L leg & trunk) taken to ER - IVF bolus 9/4/09. Poor eye contact, weak cry, dehydrated. Slowly improving, still not back to himself.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5, DTAPIPVHIB, PNC, RVX
Symptoms: Lethargy, Listless, Metabolic function test, Pyrexia, Rash maculo-papular
Clinical narrative: Received vaccines 8/31/09. Fever 101 9/3/09. Fussy, cranky, poor eye contact. 9/4/09 listless, T 103+, lethargic, bad rash (mac. pap. L leg & trunk) taken to ER - IVF bolus 9/4/09. Poor eye contact, weak cry, dehydrated. Slowly improving, still not back to himself.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5, DTAPIPVHIB, PNC, RVX
Symptoms: Social avoidant behaviour, Urine analysis
Clinical narrative: Received vaccines 8/31/09. Fever 101 9/3/09. Fussy, cranky, poor eye contact. 9/4/09 listless, T 103+, lethargic, bad rash (mac. pap. L leg & trunk) taken to ER - IVF bolus 9/4/09. Poor eye contact, weak cry, dehydrated. Slowly improving, still not back to himself.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5, DTAPIPVHIB, PNC, RVX
Symptoms: Blood count, Blood culture, Chapped lips, Constipation, Crying
Clinical narrative: Received vaccines 8/31/09. Fever 101 9/3/09. Fussy, cranky, poor eye contact. 9/4/09 listless, T 103+, lethargic, bad rash (mac. pap. L leg & trunk) taken to ER - IVF bolus 9/4/09. Poor eye contact, weak cry, dehydrated. Slowly improving, still not back to himself.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5, DTAPIPVHIB, PNC, RVX
Symptoms: Decreased appetite, Decreased eye contact, Fluid replacement, Infrequent bowel movements, Laboratory test
Clinical narrative: Received vaccines 8/31/09. Fever 101 9/3/09. Fussy, cranky, poor eye contact. 9/4/09 listless, T 103+, lethargic, bad rash (mac. pap. L leg & trunk) taken to ER - IVF bolus 9/4/09. Poor eye contact, weak cry, dehydrated. Slowly improving, still not back to himself.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5, DTAPIPVHIB, PNC, RVX
Symptoms: Lip dry, Lip haemorrhage, Pyrexia, Rash generalised, Urine analysis
Clinical narrative: Received vaccines 8/31/09. Fever 101 9/3/09. Fussy, cranky, poor eye contact. 9/4/09 listless, T 103+, lethargic, bad rash (mac. pap. L leg & trunk) taken to ER - IVF bolus 9/4/09. Poor eye contact, weak cry, dehydrated. Slowly improving, still not back to himself.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5, DTAPIPVHIB, PNC, RVX
Symptoms: Urine output decreased
Clinical narrative: Received vaccines 8/31/09. Fever 101 9/3/09. Fussy, cranky, poor eye contact. 9/4/09 listless, T 103+, lethargic, bad rash (mac. pap. L leg & trunk) taken to ER - IVF bolus 9/4/09. Poor eye contact, weak cry, dehydrated. Slowly improving, still not back to himself.
Age: 71.0
Sex: F
Vaccine: FLU3
Symptoms: Abdominal discomfort, Activities of daily living impaired, Diarrhoea, Headache, Palpitations
Clinical narrative: Thursday- Sept. 10 6pm - vaccine; 11 pm - stomach discomfort; 3 am- vomiting - 3 times; Fri - Sun - dull headache, severe diarrhea, unable to do anything. No fever. Any activity made heart race.
Age: 71.0
Sex: F
Vaccine: FLU3
Symptoms: Vomiting
Clinical narrative: Thursday- Sept. 10 6pm - vaccine; 11 pm - stomach discomfort; 3 am- vomiting - 3 times; Fri - Sun - dull headache, severe diarrhea, unable to do anything. No fever. Any activity made heart race.
Age: 34.0
Sex: M
Vaccine: FLU3
Symptoms: Cough, Dizziness, Dyspnoea, Nausea, Rhinorrhoea
Clinical narrative: Shortness of breath, coughing, lightheaded, nausea.  Running nose.
Age: 35.0
Sex: F
Vaccine: FLU3
Symptoms: Paraesthesia, Pruritus, Throat irritation, Urticaria
Clinical narrative: Shot was given in Lt arm.  Patient reported tingling & itching running up it.  Arm to Lt side of face.  Welting observed.  Throat also tingling.  FNP called.  DIPHENHYDRAMINE 50 mg given in Lt hip & an oral XYZAL mg given.  Pt responded well.
Age: 12.0
Sex: M
Vaccine: FLUN3, TDAP
Symptoms: Cough, Decreased appetite, Headache, Oropharyngeal pain, Pain
Clinical narrative: Mother called 9/18/09 @ 1:46p to report symptoms of: sore throat, sneezing, cough, headache, fever, achy, no appetite. Mom states "He gets this every year.
Age: 12.0
Sex: M
Vaccine: FLUN3, TDAP
Symptoms: Pyrexia, Sneezing
Clinical narrative: Mother called 9/18/09 @ 1:46p to report symptoms of: sore throat, sneezing, cough, headache, fever, achy, no appetite. Mom states "He gets this every year.
Age: 24.0
Sex: M
Vaccine: FLU3
Symptoms: Erythema, Induration, Local swelling
Clinical narrative: FLUVIRIN vaccine administered in Rt arm 9/16/09 @ 3:30pm and overnight developed swollen, red, hardened left side of neck.  Came back to pharmacy & advised to see MD.
Age: 82.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: On 9/18/09 this volunteer for hospital presented with erythema and "tenderness" to her right deltoid, which progressed since receiving seasonal flu vaccine on 9/16/09 at 0930. Denies need for analgesia, full ROM RUE, CSM's adeq RUE. Afebrile. Visible erythema, warm to touch R deltoid area, extends down arm to just above R elbow - exterior only. [TST neg; 0mm; on 9/18/09].
Age: 36.0
Sex: M
Vaccine: TDAP
Symptoms: Headache, Pyrexia
Clinical narrative: Next day fever, headache - 30 degrees C - took TYLENOL - Fever lasted one day - Headache lasted 2days.
Age: 17.0
Sex: F
Vaccine: TDAP
Symptoms: Chest discomfort, Chills, Dizziness, Dyspnoea, Influenza serology
Clinical narrative: Received tetanus shot 9-14-09. That night had chills, dizziness, shortness of breath and chest tightness. Had fever 101 in am. No caryza, cough, sore throat. Symptoms lasted about 24 hours.
Age: 17.0
Sex: F
Vaccine: TDAP
Symptoms: Pyrexia
Clinical narrative: Received tetanus shot 9-14-09. That night had chills, dizziness, shortness of breath and chest tightness. Had fever 101 in am. No caryza, cough, sore throat. Symptoms lasted about 24 hours.
Age: 66.0
Sex: F
Vaccine: TDAP, TYP, YF
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: Pt. given Tdap, she is over 64 yrs. of age.
Age: 13.0
Sex: M
Vaccine: FLU3
Symptoms: Erythema
Clinical narrative: Mother stated child developed 2X3inch red area on deltoid, where vaccine was administered. No other symptoms were noted. On 9/15, redness 50% improved.
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Lymphadenopathy
Clinical narrative: Pt said lymph node swollen on left side the next day.
Age: 5.0
Sex: F
Vaccine: FLUN3
Symptoms: Body temperature increased, Ear pain
Clinical narrative: Fever only up to 102 degrees 1 day later.  The patient came today at 5 years of age with complaint of elevated temperature for 2 days it  has resolved today.  Of note is the fact that the child did receive the FLUMIST vaccine on September 10 and developed a temperature elevation on September 11.  Her temperature is gone of 202 degrees with no other specific complaints.  She has had no fever today.  She does reportedly complained of some ear pain.
Age: 4.0
Sex: F
Vaccine: DTAP, FLU3, IPV
Symptoms: Erythema, Local reaction, Tenderness
Clinical narrative: Local reaction 3 - cm - Redness and tenderness no fever.
Age: 58.0
Sex: F
Vaccine: UNK
Symptoms: Body temperature increased, Erythema, Fatigue, Oedema peripheral, Pain
Clinical narrative: 9/03 injection given in afternoon woke up @ 03:30 (AM) after rolling over in bed - deltoid swollen very sore noticed redness. By following afternoon (9-4-09) redness over entire deltoid with increased swelling - redness almost to mid arm in onto inner aspect (L). T 99.4 achy & fatigue x 3 days.
Age: 58.0
Sex: F
Vaccine: UNK
Symptoms: Pain in extremity
Clinical narrative: 9/03 injection given in afternoon woke up @ 03:30 (AM) after rolling over in bed - deltoid swollen very sore noticed redness. By following afternoon (9-4-09) redness over entire deltoid with increased swelling - redness almost to mid arm in onto inner aspect (L). T 99.4 achy & fatigue x 3 days.
Age: 0.7
Sex: M
Vaccine: DTAPHEPBIP
Symptoms: Hypophagia, Irritability, Psychomotor hyperactivity, Pyrexia, Vomiting
Clinical narrative: Vomited several times bit. 7 & 10:30 PM on 8-20, vomited 1X during noc., once AM of 8-21 & once eve. of 8-21, + once on 8-22.  Was "hyper" + laughing.  Never has acted like that.  (8-22) sund. temp. R 100 degrees, 8-23 101 degrees 8-24 102 degrees, 8-25 103.6 degrees 8-26 99 degrees.  Irritable on 8-23 - 8-25.  Wouldn't eat solids, only would nurse.
Age: 55.0
Sex: M
Vaccine: PPV
Symptoms: Erythema, Pain, Pyrexia, Skin warm
Clinical narrative: The pt reported fever, pain, redness and heat to his right biceps 48 hours after injection.
Age: 9.0
Sex: M
Vaccine: HEPA, VARCEL
Symptoms: Erythema, Induration
Clinical narrative: RA swelling, erythema 8x6 cm, induration 3 1/2 x 4 cm.
Age: 7.0
Sex: M
Vaccine: FLUN3
Symptoms: Oropharyngeal pain, Pyrexia
Clinical narrative: Flumist given on Thursday, Sept. 17, 2009.  Symptoms started Saturday with sore throat and a little drainage.  By Monday, Sept. 21, low grade fever.  By Tuesday, Sept. 22, fever of 102 degrees.
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Face oedema, Rash generalised
Clinical narrative: RASH 2 HOURS POST VACCINE. LATER, SAME DAY RASH ON FACE. NEXT DAY, RASH FROM HEAD TO FEET AND FACIAL EDEMA.  WENT TO THE ER AND WAS TREATED WITH SOLUMEDROL AND ZANTAC THEN DISCHARGED. RX'S FOR HOME WERE PREDNISONE, VISTARIL AND ZANTAC.
Age: 79.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Oedema peripheral, Skin warm
Clinical narrative: she presented to the clinic with redness and swelling in left arm. swelling extended down into elbow, red and warm to touch. dr fears ordered bactrim bid
Age: 62.0
Sex: F
Vaccine: PPV, TDAP, VARZOS
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Pyrexia
Clinical narrative: CLIENT RECEIVED PNEUMOVAX VACCINE ON 09/15/2009 AND REPORTS EXPERIENCING LOW-GRADE FEVER, REDNESS, ITCHING, TENDERNESS AND SWELLING AT INJECTION SITE.  CLIENT PRESENTED TO HEALTH DEPARTMENT FOR EVALUATION ON 09/19/2009.  REDNESS, SWELLING, AND WARMTH NOTED WHICH COVERED ENTIRE RIGHT DELTOID AREA EXTENDING DOWN TO MIDWAY OF ARM. CLIENT FOLLOWED UP WITH PRIVATE PHYSICIAN AND PRESCRIBED KEFLEX FOR FIVE DAYS AND TO APLLY COLD PACK IN INJECTION.  CLIENT IN ON 09/21/2009 FOR FOLLOW-UP EVALUATION.  MINIMAL SWELLING AND REDNESS NOTED.
Age: 73.0
Sex: M
Vaccine: FLUX
Symptoms: Blood pressure decreased, Heart rate increased
Clinical narrative: an hour and a half after getting a regular flu shot(1040am) my heart rate suddenly  increased and my blood pressure dropped (1210pm). about 4:00pm my heart rate remained elevated, but my blood pressure dropped futher. i called my cardiac health nurse line to report my condition. they advised water and rest. about six hours after the reaction started, my heart rate returned to normal. my blood pressure rose, but it continued to be irratic.
Age: 1.5
Sex: F
Vaccine: DTAP, HEPA, PNC, VARCEL
Symptoms: Injection site cellulitis
Clinical narrative: Cellulitis on bilateral thighs where injections were given-patient taken to ER-given Keflex po x 7-10 days