Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Intestinal adhesion lysis, Intestinal obstruction, SARS-CoV-2 test positive, Skin abrasion, Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/11/21 (EN6205) Pfizer Dose 2 4/8/21 (EN6208) Pfizer Dose 3 10/15/21 (FF2588) COVID Positive 12/29/21  12/28/21: 76-year-old female patient with a history of bowel obstruction 3 times and subsequently had exploratory laparotomy for lysis of adhesions which were extensive. This surgery was performed on 10/17/2021 per Dr. at Hospital.  Subsequently the patient was discharged to the Hospital for further care for the wound care.  The patient was discharged with an open abdominal wound as this could not be closed.  The patient's family was unhappy with the care provided to the patient and the Hospital and hence she was transferred to another location.  And this location, the family again and noticed that due patient was covered completely in her stool and there was significant excoriation of the skin around the open wound.  The patient was then brought into the hospital today for admission. The patient could not be admitted at the first Hospital as  Dr. is available but due to the inavailability of the beds, the patient is admitted here. The emergency room physician spoke with this surgeon on-call Dr. who agreed to follow the patient here but no surgery will be performed at present.  Dr. was also called who recommended only TPN and no acute need for surgery. The patient has no history of fevers, chills, nausea or vomiting.  The patient was unfortunately fed at the hospital and hence her drainage was getting worse.  The patient has no other complaints at this point.  1/7/22: 76-year-old female patient with a history of bowel obstruction 3 times and subsequently had exploratory laparotomy for lysis of adhesions which were extensive. This surgery was performed on 10/17/2021 per Dr. at Hospital.  Subsequently the patient was discharged to the Hospital for further care for the wound care.  The patient was discharged with an open abdominal wound as this could not be closed.  The patient's family was unhappy with the care provided to the patient at the Hospital and hence she was transferred to another location.  At this location, the family again  noticed that patient was covered completely in her stool and there was significant excoriation of the skin around the open wound.  The patient was then brought into the hospital for admission.  The patient could not be admitted at the first Hospital as  Dr. is available but due to the lack of the beds, the patient was admitted here.   Patient was noted to be positive for the SARS-CoV-2 virus infection.  She was totally asymptomatic did not have any fevers or hypoxia.  The wound nurse was consulted who had the patient with the wound VAC and also surgery consultation was obtained.  The patient was also started on TPN.  Education and instructions given to the family with regards to Accuchecks and TPN administration.  Patient will see the surgeon 1st prior to being discharged home at his clinic.  Patient will have visiting nurses services.  All questions answered at the time of discharge.  Patient will follow up with PCP in 1 week.