chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 5.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Head injury, Headache, Mouth haemorrhage, Pain in jaw, Restlessness
Clinical narrative: Patient received the vaccine while seated, got up and walked a few feet, returned to room, fainted then fell to floor hitting head; picked up by mother, placed on cart, O2 administered, head tilt/chin lift  done; HR and pulse ox monitors applied; pt responded within a minute or so, crying/confused, c/o headache, with contusion and abrasion to chin, c/o jaw pain and no stated "Am I done yet mommy?"; pt bit tongue on both sides with minimal bleeding noted, resolved quickly; pt given 150mg Ibuprofen at request of mother and po sips of water; pt rested on cart for approximatley 30-45 minutes, then left, carried by mother where pt was taken to see ED physician who is family friend for evaulation; no further recommendations from ED physician; pt taken home, ate dinner without difficulty although con't to c/o chin and jaw pain; rested; bed by 830 pm after medicated with acetaminophen; patient woke up a couple of times in night, appeared restless, returned to sleep after briefly being consoled by mother. Woke up next am without difficulty, worried about eating breakfast and hurting jaw; medicated with acetaminophen and ibuprofen; appeared to act normally except for being scared about previous events.
Age: 5.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Syncope, Tongue biting
Clinical narrative: Patient received the vaccine while seated, got up and walked a few feet, returned to room, fainted then fell to floor hitting head; picked up by mother, placed on cart, O2 administered, head tilt/chin lift  done; HR and pulse ox monitors applied; pt responded within a minute or so, crying/confused, c/o headache, with contusion and abrasion to chin, c/o jaw pain and no stated "Am I done yet mommy?"; pt bit tongue on both sides with minimal bleeding noted, resolved quickly; pt given 150mg Ibuprofen at request of mother and po sips of water; pt rested on cart for approximatley 30-45 minutes, then left, carried by mother where pt was taken to see ED physician who is family friend for evaulation; no further recommendations from ED physician; pt taken home, ate dinner without difficulty although con't to c/o chin and jaw pain; rested; bed by 830 pm after medicated with acetaminophen; patient woke up a couple of times in night, appeared restless, returned to sleep after briefly being consoled by mother. Woke up next am without difficulty, worried about eating breakfast and hurting jaw; medicated with acetaminophen and ibuprofen; appeared to act normally except for being scared about previous events.
Age: 66.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Herpes zoster, Oedema peripheral
Clinical narrative: PATIENT DEVELOPED SHINGLES OUT BREAK IN SMALL AREA ALONG LEFT SIDE ABOUT ON THE WAIST LINE.  PATIENT ALSO HAD A VERY RED AND SWOLLEN ARM FOR ABOUT 3 DAYS.
Age: 45.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Asthenia, Dizziness, Fatigue, Headache, Hypoaesthesia facial
Clinical narrative: Moderate to severe dizziness; numbness and tingling in jaw/face; lightheadedness, headache; weakness/fatigue.  Reactions began within 5-10 minutes of injection.  As of 1:45 pm 11/24/09, symptoms still present.
Age: 45.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Paraesthesia
Clinical narrative: Moderate to severe dizziness; numbness and tingling in jaw/face; lightheadedness, headache; weakness/fatigue.  Reactions began within 5-10 minutes of injection.  As of 1:45 pm 11/24/09, symptoms still present.
Age: 8.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Erythema, Rash
Clinical narrative: Generalized rash increased, redness.
Age: 48.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Chills, Headache, Pain, Pyrexia, Rhinorrhoea
Clinical narrative: 11/18-Chills all over the body. 11/19-Runny nose, headache, body aches, fever.
Age: 2.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Diarrhoea, Vomiting
Clinical narrative: Frequent vomiting for 48 hours, followed by severe diarrhea for the next 72 hours. Vomiting/diarrhea for five days total.
Age: 7.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Sensation of foreign body
Clinical narrative: 5 minutes after nasal mist "throat feels like something needs to be cleared out." Had drink of H2O, vitals done.  Discharged per MD.
Age: 2.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Diarrhoea, Vomiting
Clinical narrative: Frequent vomiting for 60 hours, followed by severe diarrhea for the next 72 hours. Vomiting/diarrhea for five and a half days total.
Age: 35.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Rash
Clinical narrative: Rash on trunk and arms.  PT took Benadryl at onset of symptoms.  Symptoms resolved over following 4 hours without recurrence.
Age: 9.0
Sex: F
Vaccine: FLU(H1N1), PPV
Symptoms: Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
Clinical narrative: Redness, swelling at site. Progressed to pain with fever of 103, inability to move limb.  Was given antibiotics at Urgent Care.
Age: 1.28
Sex: F
Vaccine: FLUX, FLUX(H1N1), HEPA, MU
Symptoms: Hypersomnia, Pyrexia, Vomiting
Clinical narrative: Fell into deep asleep 5 hrs earlier than usual for 6 continuous hours.  Then woke up with 105 degree fever.  Gave Tylenol. No effect.  Then Motrin + Tylenol together helped.  3 continuous days fevers, vomiting six times, emergency hospital twice.  Doctor once.
Age: 56.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Dyspnoea, Lip swelling, Pruritus, Rash, Urticaria
Clinical narrative: Welts on face, itching, chest rash later onset, followed by legs.  Lips swollen.  Some difficulty breathing.
Age: 6.0
Sex: M
Vaccine: FLUN(H1N1)
Symptoms: Dysphonia, Urticaria
Clinical narrative: Hoarse, Hives around eyes (bad), hair line, mouth, shoulders, neck and minor on his back.  Child got the hives on and off for three days (so far).  Would go away after shower, medicine and topical ointment, but would come back a few hours later.
Age: 13.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Injection site rash
Clinical narrative: Circular rash around injection site, rash resolved. Benadryl given.
Age: 8.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Animal scratch, Chest X-ray, Differential white blood cell count, Electrocardiogram, Erythema
Clinical narrative: Small red papules appeard on legs that pm.  Seen in office on 11-23-09 due to increase in size of bumps and more noted to legs.  Rt. anterior leg half dollar size, oval, tender to touch, no discharge, no adenopathy.  Smaller red papules on lt. lateral thigh, smaller papules on rt. leg noted. Diagnosed with Erythema Nodosum.
Age: 8.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Erythema nodosum, Full blood count, Rash papular, Red blood cell sedimentation rate, Streptococcal identification test
Clinical narrative: Small red papules appeard on legs that pm.  Seen in office on 11-23-09 due to increase in size of bumps and more noted to legs.  Rt. anterior leg half dollar size, oval, tender to touch, no discharge, no adenopathy.  Smaller red papules on lt. lateral thigh, smaller papules on rt. leg noted. Diagnosed with Erythema Nodosum.
Age: 26.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: CSF test, Demyelination, Dystonia, Nuclear magnetic resonance imaging brain abnormal
Clinical narrative: Dystonia of left upper extremity. MRI brain on 11/22/2009 reveals multiple areas of demyelination. Concern for ADEM. Patient has had no prior symptoms. Patient does not meet criteria for multiple sclerosis.  11/25/09 Hospital neurological consultation received. Service date: 11/22/09. Assessment: Left upper extremity tonic activity. Patient presented with frequent intermittent left extremity stiffening spells. 5-10 second duration, tonic-like activity. Left upper and lower extremity weakness.  12/17/09 Hospital records, discharge summary received. Service dates 11/22/09 to 11/25/09. Assessment: Acute disseminated encephalomyelitis. Patient presented with frequent intermittent left extremity stiffening spells. Oral contraceptives.
Age: 18.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Oropharyngeal pain, Pyrexia
Clinical narrative: Fever of 102 degrees with sore throat.
Age: 15.0
Sex: F
Vaccine: HPV4
Symptoms: Convulsion, Foaming at mouth, Gaze palsy, Tonic clonic movements, Vomiting
Clinical narrative: Within a minute of receiving HPV vaccine pt began to have a seizure. Tonic clonic movements with eyes rolling, foaming at the mouth with vomiting. 12/2/2009 PCP records for 11/16 and 11/25/2009, patient with c/o's lightheadedness, vomiting, LOC for 10 seconds post vaccine. Dx vasovagal syndrome. No tx noted
Age: 3.0
Sex: F
Vaccine: FLUN3
Symptoms: Anger, Antisocial behaviour, Hostility, Insomnia, Lethargy
Clinical narrative: Lethargy within 2 hours. Antisocial behavior next day with anger, and hostility. Withdrawn and rebellious activity. Slight fever next day. Insomnia x1 week. Sx lasted 2 weeks.
Age: 3.0
Sex: F
Vaccine: FLUN3
Symptoms: Pyrexia, Social avoidant behaviour
Clinical narrative: Lethargy within 2 hours. Antisocial behavior next day with anger, and hostility. Withdrawn and rebellious activity. Slight fever next day. Insomnia x1 week. Sx lasted 2 weeks.
Sex: F
Vaccine: FLUX
Symptoms: Chest discomfort, Dyspnoea, Muscular weakness, Palpitations, Vaccine positive rechallenge
Clinical narrative: Initial case received from a health care professional, who is also the patient, on 10 November 2009. A female patient reported that she received an influenza vaccine (manufacturer, lot number, and date of administration not reported) "two years ago". Three days post-vaccination, she experienced shortness of breath, palpitations, chest pressure, and left arm weakness lasting several weeks. The following year she experienced a similar reaction but reported that it was not as severe. No additional information was reported. Documents held by sender: None.
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Back pain, Blister, Chest pain, Erythema
Clinical narrative: Severe pain in back and lower right chest. Red, then little blister.
Age: 65.0
Sex: F
Vaccine: FLU3
Symptoms: Facial palsy, Facial paresis, Nuclear magnetic resonance imaging brain normal
Clinical narrative: Initial report received on 14 November 2009 from an investigator. A 66 year old female subject developed BELL'S palsy on 7 November 2009 i.e. 33 days after receiving an intramuscular injection of FLUZONE SV 2009-2010 on 5 October 2009 in left arm (UD12321). The subject had medical history of left bundle branch block, mitral valve prolapse, migraine, hypothyroidism, hypercholesterolemia, gastroesophageal reflux disease, irritable bowel syndrome, arthritis, cataracts. The subject was on concomitant medications NORVASC, VYTORIN, PRILOSEC, LOTRONEX, SYNTHROID, CELEBREX. On 7 November 2009, the subject developed facial weakness and was diagnosed with BELL'S palsy. No treatment prescribed by her neurologist. Magnetic resonance imaging (MRI) of her brain was negative (per subject). She will follow up with ophthalmologist for additional care. Corrective treatment details were not provided. The events of BELL'S palsy and facial weakness were ongoing at the time of this report. According to the investigator, the event was related to the study vaccine. The serious adverse event did not lead to the termination of the subject from the study. List of the documents held by sender: None.
Age: 55.0
Sex: F
Vaccine: FLU3
Symptoms: Blood pressure increased, Dyspnoea, Emergency care, Oedema peripheral, X-ray
Clinical narrative: Shot was given around 11:30 AM. Didn't notice arm swollen until evening. Was sleeping hrs. after shot. From elbow to shoulder was the size of my calf on leg. No pain. Next morning couldn't breathe. Went to E.R., took x-rays, monitor heart and pressure HIGH! Shot is on back of arm, move towards shoulder. Shot might have hit a vein?
Age: 20.0
Sex: M
Vaccine: TDAP
Symptoms: Chills, Dizziness, Pyrexia, Tremor
Clinical narrative: Fever, chills, shakes, dizziness for 6 hours. Self treatment
Age: 28.0
Sex: M
Vaccine: RAB
Symptoms: Lymphadenopathy, Pyrexia
Clinical narrative: Fever, swollen lymph nodes. No TX. Reported better now, lymph nodes decreased in size.
Age: 33.0
Sex: F
Vaccine: FLU3
Symptoms: Bursitis, Injection site pain, Musculoskeletal pain, Nuclear magnetic resonance imaging
Clinical narrative: Experienced soreness/pain after injection that did not resolve. Left shoulder pain continued. Went to the doctor on 11-4-09 and was diagnosed with bursitis, given naproxen and prednisone. Pain had resolved somewhat, but not completely.
Age: 46.0
Sex: F
Vaccine: FLU3
Symptoms: Myalgia, Pyrexia
Clinical narrative: On 10-04-09 I received a vaccination for flu. I was told I might have mild muscle soreness. On 10-04-09 at night I had fever and muscle soreness, second day fever w/muscle soreness since 10-07-09. I have lived w/muscle soreness that is not going away it is getting worst.
Age: 16.0
Sex: M
Vaccine: MNQ
Symptoms: Abdominal pain upper, Blood test, Chest X-ray, Electroencephalogram, Grand mal convulsion
Clinical narrative: Patient had 2 grand mal seizures 4.5 days following his MENINGOCOCCAL vaccine.  Stomach ache night before.  Started vomiting @ 2:30.  Vomited 3-4 times.  First seizure @ 10:30 AM duration of 30 sec.  Two hours later second seizure in E.R.  Lasted 45 seconds.  No prior seizure history or adverse reactions to vaccinations.  Anti seizure Med. 11/25/09 ER records received for date 7/25/09 to 7/26/09. DX: gran mal seizures, GERD, elevated creatinine, recent meningococcal vaccine. Pt. presented to ER via EMS. Had witnessed seizure, postictal on arrival to ER. Witnesses of pt seizure states pt had contractile seizure, some shaking, pt not aware, foaming from mouth. At ER pt had vomiting and diarrhea.  Assessment: tachycardia RR, headache, weakness, sleepy. Pt was (+)HA, N&V, prior to seizure 12/3/09 Medical records received for DOS 11/7. Final DX: seizure w/sub therapeutic Dilantin level. H/O seizure disorder. C/O seizure x2.  H1N1 vax on 10/30/09.  Dilantin level sub therapeutic.
Age: 16.0
Sex: M
Vaccine: MNQ
Symptoms: No reaction on previous exposure to drug, Nuclear magnetic resonance imaging, Scan brain, Vomiting
Clinical narrative: Patient had 2 grand mal seizures 4.5 days following his MENINGOCOCCAL vaccine.  Stomach ache night before.  Started vomiting @ 2:30.  Vomited 3-4 times.  First seizure @ 10:30 AM duration of 30 sec.  Two hours later second seizure in E.R.  Lasted 45 seconds.  No prior seizure history or adverse reactions to vaccinations.  Anti seizure Med. 11/25/09 ER records received for date 7/25/09 to 7/26/09. DX: gran mal seizures, GERD, elevated creatinine, recent meningococcal vaccine. Pt. presented to ER via EMS. Had witnessed seizure, postictal on arrival to ER. Witnesses of pt seizure states pt had contractile seizure, some shaking, pt not aware, foaming from mouth. At ER pt had vomiting and diarrhea.  Assessment: tachycardia RR, headache, weakness, sleepy. Pt was (+)HA, N&V, prior to seizure 12/3/09 Medical records received for DOS 11/7. Final DX: seizure w/sub therapeutic Dilantin level. H/O seizure disorder. C/O seizure x2.  H1N1 vax on 10/30/09.  Dilantin level sub therapeutic.
Age: 16.0
Sex: F
Vaccine: HPV4, MNQ
Symptoms: Unevaluable event
Clinical narrative: None stated
Age: 75.0
Sex: F
Vaccine: FLUX, PPV
Symptoms: Injection site erythema, Injection site swelling, Pain in extremity
Clinical narrative: Pt complained of sore arm from PPV2s Shot. PHN observed 3cm from shot site a 4cm x 3cm red swollen area. Pt does not believe it to be related to bandaid. Pt complained arm was more sore the day before. Flu shot was also given without event. Pt said arm felt better today.
Age: 26.0
Sex: F
Vaccine: HEP
Symptoms: Asthenia, Dizziness, Headache
Clinical narrative: Dizziness/lightheaded @ 2:30 - evening severe headache and weakness @ 7:30 am - 4:30 weakness continued through evening.
Age: 50.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Oedema peripheral, Rash macular
Clinical narrative: Sudden edema bilateral lower legs, red splotches both legs.
Age: 65.0
Sex: F
Vaccine: PPV
Symptoms: Cellulitis, Erythema, Pain in extremity, Rash macular
Clinical narrative: RT arm pain, erythema, blotches (Cellulitis like within 48 hours of receiving vaccine)
Age: 2.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Arthralgia, Generalised oedema
Clinical narrative: Generalized edema.  Joint pain.
Age: 1.29
Sex: M
Vaccine: HIBV
Symptoms: Unevaluable event
Clinical narrative: RN drew up vaccines for twin siblings they were both to receive 15 mth shots so (4 each). I set up the vaccines in doubles and did not separate with each child thus when I didn't add diluent to hip I don't know which child received just the diluent.
Age: 17.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Paraesthesia, Pruritus, Urticaria
Clinical narrative: Complained of itching - tingling of hands and hives. No shortness of breath or tongue swelling. BENADRYL IM.
Age: 19.0
Sex: M
Vaccine: MMR
Symptoms: Autism
Clinical narrative: Information has been received from a nurse concerning her friend's approximately 19 year old son who on an unspecified date in approximately 1991 (18 years ago) was vaccinated with a dose of MMR II (Wistar RA 27/3) (HSA, lot#, route and site of administration not reported). Subsequently, the patient was autistic after vaccination. At the time of this report, the patient's outcome was unknown. Upon internal review, being autistic was considered to be an other important medical event. This is one of several reports from the same source. No further information is available.
Age: 4.0
Sex: U
Vaccine: DTAP
Symptoms: Erythema, Oedema peripheral
Clinical narrative: Red, swelling area Rt upper arm
Age: 19.0
Sex: M
Vaccine: MMR
Symptoms: Autism
Clinical narrative: Information has been received from a nurse concerning her friend's approximately 19 year old son who on an unspecified date in approximately 1991 (18 years ago) was vaccinated with a dose of MMR II (HSA, lot#, route and site of administration not reported). Subsequently, the patient was autistic after vaccination. At the time of this report, the patient's outcome was unknown. Upon internal review, being autistic was considered to be an other important medical event. This is one of several reports from the same source. No further information is available.
Age: 18.0
Sex: F
Vaccine: UNK
Symptoms: Chest discomfort
Clinical narrative: 4:52 arrived complaining of tightness in chest.
Age: 1.29
Sex: F
Vaccine: HIBV
Symptoms: Incorrect dose administered
Clinical narrative: RN drew up vaccines for twin siblings. They were both to receive 15 month shots (4 each). I set up the the vaccines in doubles and did not separate vaccines with each child, thus when I didn't add diluent to HIB - I didn't know which child received just the diluent and which the HIB.
Age: 78.0
Sex: M
Vaccine: UNK
Symptoms: Myalgia
Clinical narrative: Severe muscle aches in upper left back and left chest starting one hour after getting seasonal flu shot.
Age: 70.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, No reaction on previous exposure to drug
Clinical narrative: Information has been received from a physician assistant concerning a 70 year old female patient with hypertension, hyperlipidaemia, depression and no drug reactions/allergies who "5 years ago" approximately in November 2004, was vaccinated with the first dose of PNEUMOVAX 23. Patient did not have any reactions after first dose. On 17-Nov-2009 the patient was vaccinated intramuscularly with the second dose of 0.5 ml PNEUMOVAX 23 (lot # 664000/0621Y). Concomitant therapy included simvastatin (MS, DYAZIDE, ZOLOFT. on 17-Nov-2009 the patient experienced injection site reaction as hot to touch, not as bright red as the reaction from the other patients, swelling, painful that went from the top of the shoulder area almost to the top of the elbow all the way around the arm. The patient is applying hot packs and BENADRYL to the area as intervention to prevent serious criteria. The patient had sought medical attention via office visit. No laboratory diagnostic study was performed. at the time of reporting, the outcome of the event was unknown. Injection site reaction as hot to touch, swelling and painful that went from the top of the shoulder area almost to the top of the elbow all the way around the arm were considered as other important medical events by the reporter. This is one of several reports received from the same source. Additional information has been requested.
Age: 70.0
Sex: F
Vaccine: PPV
Symptoms: Pain in extremity
Clinical narrative: Information has been received from a physician assistant concerning a 70 year old female patient with hypertension, hyperlipidaemia, depression and no drug reactions/allergies who "5 years ago" approximately in November 2004, was vaccinated with the first dose of PNEUMOVAX 23. Patient did not have any reactions after first dose. On 17-Nov-2009 the patient was vaccinated intramuscularly with the second dose of 0.5 ml PNEUMOVAX 23 (lot # 664000/0621Y). Concomitant therapy included simvastatin (MS, DYAZIDE, ZOLOFT. on 17-Nov-2009 the patient experienced injection site reaction as hot to touch, not as bright red as the reaction from the other patients, swelling, painful that went from the top of the shoulder area almost to the top of the elbow all the way around the arm. The patient is applying hot packs and BENADRYL to the area as intervention to prevent serious criteria. The patient had sought medical attention via office visit. No laboratory diagnostic study was performed. at the time of reporting, the outcome of the event was unknown. Injection site reaction as hot to touch, swelling and painful that went from the top of the shoulder area almost to the top of the elbow all the way around the arm were considered as other important medical events by the reporter. This is one of several reports received from the same source. Additional information has been requested.
Age: 13.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Erythema, Swelling
Clinical narrative: Redness, swelling measuring 55 x 65 cm.
Age: 0.11
Sex: U
Vaccine: HEP
Symptoms: Urticaria
Clinical narrative: Urticarial rash following injection
Age: 25.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Rash
Clinical narrative: Rash- Benedryl 50mg po. stat.
Age: 48.0
Sex: M
Vaccine: FLU3
Symptoms: Optic neuritis, Visual field tests
Clinical narrative: optic neuritis 12/10/2009 PCP visit 11/12/2009 f/up visit for rt optic neuritis, taking steroids for tx, c/o's not sleeping well otherwise no problems, scheduled for further dx tests 11/19/2009  12/29/09 Medical records received for dates 10/7/09 to 12/4/09. DX:optic papilitis, optic neuritis OD, s/p recent IV solumedrol now w/ disc edema OS amaurosis sx decreased vision, Central scotoma, optic neuritis, venous thrombosis, eye problems, disk edema. CC: vision changes, eye pain. Multiple ophthalmology visits.
Age: 23.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Asthenia, Chills, Fatigue, Headache, Myalgia
Clinical narrative: Sore Throat, Headache, Chills, Tiredness/Weakness, Paleness, Fever, Muscle Aches.
Age: 23.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Oropharyngeal pain, Pallor, Pyrexia
Clinical narrative: Sore Throat, Headache, Chills, Tiredness/Weakness, Paleness, Fever, Muscle Aches.
Age: 47.0
Sex: F
Vaccine: FLU(H1N1), FLU3
Symptoms: Blister
Clinical narrative: Blisters noted on upper and lower lip (left side).  No drainage.
Age: 26.0
Sex: F
Vaccine: FLU(H1N1), FLUX
Symptoms: Arthritis, Drug exposure during pregnancy
Clinical narrative: Asymmetric, oligoarthritis of the ankles, knees, and hands.  12/01/09 MR received for DOS 11/19.  DX: Asymmetric mild arthritis  On 11/01/09, Pt was seen in ED with c/o polyarthritis, joint swelling and warm, and decreased ROM. On 11/19/09, rheumatologic assessment: negative for infection, possibly temporal relationship to vaccines. Tx: APAP. Pt's symptoms resolved spontaneously.
Age: 39.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Dysphonia, Eye pruritus, Eye swelling, Facial pain, Musculoskeletal pain
Clinical narrative: Pain in neck and shoulder, right sided facial pain, right eye swollen, hives on lower lid, right worse than left, eyes itchy, hoarseness in throat.
Age: 39.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Neck pain, Urticaria
Clinical narrative: Pain in neck and shoulder, right sided facial pain, right eye swollen, hives on lower lid, right worse than left, eyes itchy, hoarseness in throat.
Age: 63.0
Sex: F
Vaccine: FLU(H1N1), FLU3
Symptoms: Immediate post-injection reaction, Injection site pain, Injection site reaction, Pain in extremity
Clinical narrative: Immediately upon receiving H1N1 (L) arm began to hurt. Called 11/16 stating painful with "kernel" at injection site when she pressed on it. Rec. heat; unble to take NSAIDS- taking Tylenol- 11/19 followed instructions- to call me back if no improvement. Called still sore, "kernel" gone. Taking Trimadol for pain- Rec. ER if continuance of pain.
Age: 21.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Oedema peripheral, Rash, Urticaria
Clinical narrative: Hives and rash lasting 5 hours, Foot and Hand swelling lasting 2 hours - Benadryl 50 mg po x1 alleviated all symptoms.
Age: 47.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Body temperature increased, Feeling abnormal, Mobility decreased, Pain in extremity, Presyncope
Clinical narrative: Reported received H1N1 vaccine in right arm on Wed. 11-18-09. On Fri. 11-20-09 noted feeling bad all over, had excruciating pain in right arm, unable to use or lift arm due to pain.  Reported to facility ICP who advised her to seek medical attention. Patient f/u with physician.  Temp. at physician office was 99.9, felt faint in office. No test were done. Dr. informed her it appeared she had some sort of reaction to the vaccine. Prescribed Naprosyn for pain relief. No other f/u treatment recommended.  Patient reported today 11-24-09 that she only has some soreness in the right arm, the excruciating pain is gone.  She can now lift her arm.
Age: 38.0
Sex: F
Vaccine: FLUX(H1N1)
Symptoms: Chest discomfort, Dysgeusia
Clinical narrative: C/o metallic taste in her mouth tightness in chest - took a nebs treatment.
Age: 65.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Oedema peripheral, Pruritus, Skin burning sensation
Clinical narrative: C/O hands and forearm started to itch and burn 1 hr after vaccine, no redness, no temp, no hives, C/O hand swelling.
Age: 9.0
Sex: F
Vaccine: FLUN3, HPV4
Symptoms: Gait disturbance, Lumbar puncture normal, Pain in extremity, Weight bearing difficulty
Clinical narrative: Pain in the legs and inability to bear weight. Started on 11/5/09 (about 8 pm) and was seen in the medical office on 11/6/09 and then in the ER, (hospital) the same night; and again on 11/9/09. Transferred to another hospital; discharged on 11/11/09. Was still not ambulating. LP done - was normal.  12/2-12/8 Discharge summary and medical records received for DOS  11/9-11/11. Final DX:  Lower extremity pain. PTSD.  Acute onset tingling bil feet. Progressive sharp pain ascending to knees.  Fell to floor. Legs too weak to walk.  Transient macular rash on face resolved.  Knee/ankle joint pain. Diarrhea. Psych eval revealed PTSD and h/o abuse. All diags WNL.  Improved w/NSAIDs. OT/PT planned.
Age: 49.0
Sex: F
Vaccine: FLUN3
Symptoms: Condition aggravated, Facial pain, Nuclear magnetic resonance imaging normal, Pain
Clinical narrative: Approx 40-45 days following vaccine receipt, developed left facial pain across jaw and zygomatic arch, worse at night. No numbness or tingling. No visual or other sensory sx's. No rashes. 11/12/09, Seen by PCM --> A/P: Trigeminal Neuralgia vs muscle strain w/(+) masseter/buccinator trigger points --> NEURONTIN; ROBAXIN, PM&R, Facial MRI (Pending); seen by Dentist - pain not felt to be r/t dental issues). Symptoms: Pain.
Age: 32.0
Sex: M
Vaccine: FLUX
Symptoms: Body temperature increased, Myalgia, Pain, Pyrexia
Clinical narrative: Receipt of seasonal influenza vaccine on 11/6/09. No other vaccines were received on that day. Within 40 minutes of vaccine receipt, service number (SM) developed an elevated temperature (measured, highest reading -103) and intense generalized body aches. His fevers continued for about 4 days and the myalgias lasted about 3 days. He denies associated rashes, angioedema, joint pain, headaches, N/V, dyspnea, or increased fatigue. SM did not seek medical evaluation, but self treated with Ibuprofen w/o significant improvement of symptoms. He denied  symptoms of infection or exposures to sick contacts prior to vaccine receipt. He denies previous adverse reactions following vaccine receipt.
Age: 9.0
Sex: M
Vaccine: FLU3
Symptoms: Crying, Grimacing, Hypoaesthesia, Neck pain
Clinical narrative: 10am recv'd flu shot L arm. 11:30am c/o severe neck pain and numbness L upper arm. Cried, grimaced > 30 mins from severe pain. Ice pack applied, positioned in reclined posotion. 11:40am: HR 88, RR 20, BP 135/90. T 99.3. 12 noon: HR 80, RR 20, BP 124/90. Mother infomed, picked up at 12:53pm and recommended be seen by PCP that day. MD told mother to administer TYLENOL. Student slept at home adn today 11/6 has no pain (per mother).
Age: 8.0
Sex: M
Vaccine: FLU3
Symptoms: Dizziness, Pyrexia
Clinical narrative: Dizziness, fever 101.4. Rest, ice pack, water, parent picked up. Rechecked - 100.8. Student said feeling better.
Age: 5.0
Sex: M
Vaccine: FLU3
Symptoms: Pallor
Clinical narrative: Child noted pale at sx monitoring station, escorted to health room 8:50. Had ch lay - legs elevated. Wet cool compresses to forehead. V/S/ taken. Parent notified 9:10. Reassessed 9:15. Child recovered. Returned to class after 1 hr.
Age: 11.0
Sex: M
Vaccine: FLU3
Symptoms: Injection site pain, Injection site pruritus, Injection site rash
Clinical narrative: Vaccinated with seasonal flu shot in upper left arm at approximately 8:30am. Returned to clinic at 9:55am complaining of pain at injection site and itchiness to left arm. Raised rash to upper left and upper right arm. No hives. No difficulty breathing. Mother contacted at approx. 10:03. Father contacted and came to clinic - took son to doctor after leaving clinic at 10:34am.
Age: 8.0
Sex: M
Vaccine: FLU3
Symptoms: Syncope
Clinical narrative: Fainting after receiving TIV administration. No LOC; after 1-2 minutes, alert/oriented/quiet; No SOB, no hypotension. VS stables x 5. Treatment: supine x 20 minutes, legs elevated, rest, close observation, monitoring for sx/s allergic reaction.
Age: 0.13
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5
Symptoms: Erythema, Irritability, Local swelling, Skin warm, Tenderness
Clinical narrative: Irritability starting 4-6 hours after shot. No severe fever and local swelling, redness, warmth, tenderness lasts 2-4 hrs. resolved.
Age: 65.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Ear pain, Immediate post-injection reaction, Injection site pain, Neck pain, Pain
Clinical narrative: Received pain after injection; woke up with (L) ear, (L) neck pain, rash on top of left shoulder; sharp pains radiate to (L) ear; PCP evaluated & prescribed MEDROL dose pack for one week.
Age: 5.0
Sex: F
Vaccine: DTAPIPVHIB, FLU(H1N1)
Symptoms: Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Local shot site reaction: and tenderness warmth & swelling subsiding after 36hrs.
Age: 66.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Asthenia, Dyspnoea, Flushing, Headache, Hot flush
Clinical narrative: Immediate heat wave felt. Had hives on both arms, flushing. Heat waves intermitant. Difficulty breathing. Given 02 seated. Sent to ER via ambulance. BENADRYL X 2 before reaching hosp. IV's and med. Discharged at MN. HA at MN at home. Rx for PREDNISONE QID x 2 days. Weak today - day after.  HYDROXINE 1 TID PRN at home.
Age: 66.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Immediate post-injection reaction, Temperature intolerance, Urticaria
Clinical narrative: Immediate heat wave felt. Had hives on both arms, flushing. Heat waves intermitant. Difficulty breathing. Given 02 seated. Sent to ER via ambulance. BENADRYL X 2 before reaching hosp. IV's and med. Discharged at MN. HA at MN at home. Rx for PREDNISONE QID x 2 days. Weak today - day after.  HYDROXINE 1 TID PRN at home.
Age: 32.0
Sex: M
Vaccine: ANTH
Symptoms: Injection site nodule, Injection site pruritus, Nodule, Pruritus
Clinical narrative: Since he received Anthrax vaccine, SM notes recurrent pruritic nodules at AVA vaccine site on left upper arm. Denies significant local reaction or related systemic symptoms. A nodule about the size of a marble appears at old vaccination site and is extremely itchy. It lasts a few days and resolves, and then recurs again in about 3 weeks.
Age: 13.0
Sex: F
Vaccine: FLUN(H1N1), VARCEL
Symptoms: Injection site pain, Injection site warmth, Rash erythematous
Clinical narrative: At office visit on 11/20/2009 patient received a Varivax injection into left arm she also received the H1N1 nasal flumist.  Approximately 24 hours later the patient complained to her mom about her left arm at the injection site being warm and tender to touch.  She developed a rash which was relatively sparce large erythematous papules, no vesicles noted over her arms, back and abdomen.  The urgent care doctor spoke with the ID fellow who stated that no special prophylaxis was recommended at present. patient is following-up with pcp on 11/24/2009.
Age: 38.0
Sex: F
Vaccine: FLU3, FLUN(H1N1), TDAP
Symptoms: Injection site pruritus, Rash
Clinical narrative: Itching the right upper arm, then rash spread to forearm.  Treated with Benadryl cream and pills.
Age: 35.0
Sex: F
Vaccine: FLU(H1N1), FLUX
Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Haemorrhage, Muscle spasms
Clinical narrative: Miscarriage - cramping, bleeding. Doctor visit the following morning determined pregnancy no longer viable. 12/1/09 Medical records received for date 11/2/09. GYN DX: threatened AB vs missed AB. Pt presented w/ c/o vaginal bleeding/cramping states positive pregnancy test approx 6wks pregnant. 12/2/09 Medical records received for date 10/29/09. Pt given H1N1 vax and seasonal flu vax. Presented ot office w/ c/o possible pregnancy has c/o breast tenderness, fatigue urinary complaints.
Age: 6.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Abdominal pain upper
Clinical narrative: C/O "stomach ache" after receiving Flumist. PC to mother @ 12:20 pm- child remained @ school. Recovered at school.
Age: 44.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Cough, Dysgeusia, Postnasal drip
Clinical narrative: Right After the vaccine I developed alot of post nasal drip and a metallic taste in my mouth. About 1 hour later I developed an cough which lasted for a few hours. The cough was very bothersome but eventually subsided by the next day. Since then I feel fine with no other symptoms. Lot # UP016AA Exp. 03/30/2011
Age: 18.0
Sex: M
Vaccine: FLU(H1N1), FLU3
Symptoms: Rash, Urticaria
Clinical narrative: Onset of urticarial rash on trunk and LUE.  Had resolved by 10-30-2009.
Age: 9.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Abdominal pain upper, Body temperature increased, Malaise, Vomiting
Clinical narrative: C/O stomach ache within 30 minutes of receiving flumist. Temp 100.4 @ interview with child. Child stated she was sick & vomited 5 times the night prior.
Age: 41.0
Sex: F
Vaccine: FLUX(H1N1)
Symptoms: Arthralgia, Injection site pain, Neck pain
Clinical narrative: Soreness at injection site.  Progressing to pain up to neck and down to elbow.  Pain present for 1 week at this point.
Age: 9.0
Sex: M
Vaccine: FLU3, FLUN(H1N1)
Symptoms: Pruritus, Rash maculo-papular
Clinical narrative: Patient developed a generalized maculopapular rash starting on the trunk spreading to the face and arms with itching noted. No respiratory involvement noted. Patient did not appear ill. Good activity level and appetite.
Age: 1.34
Sex: M
Vaccine: DTAP, HEPA
Symptoms: Eyelid oedema, Urticaria
Clinical narrative: Parent states that @ 9pm on 11/23/09 child started with hives on chin @ first then to face legs, back, and trunk of the childs body. Child also had mild swelling to eyelids resolved < 1hr. Parent indicated that child had french fries for the first 1 1/2 hr prior to onset of the hives. Child referred to allergy clinic.
Age: 3.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Cyanosis, Hypotonia, Hypoventilation, Intensive care, Pallor
Clinical narrative: 10 min. after receiving vaccine, pt. was at home when he became very pale and limp.  He was placed on the floor.  He vomited x1.  His breathing was slow and shallow and lips appeared to be blue.  EMS was called. He was awake, and alert and "appeared fine" when they arrived.  They transported him to Hospital.  He was admitted into ICU for observation.  Mother states final diagnosis was vasovagal reaction to injection.  He is fully recovered. 12/03/09 ED  and Hospital records received for DOS 11/11-11/12/09. Pt. presented with history of eyes rolling back in head, shallow breathing, vomiting at home 30 minutes after receiving vaccine.  Pallor, cyanosis noted while in ER. Admitted to pediatric ICU. Cardiology, Neurology consults obtained. DX: Possible vasovagal reaction
Age: 3.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Presyncope, Respiratory rate decreased, Vomiting
Clinical narrative: 10 min. after receiving vaccine, pt. was at home when he became very pale and limp.  He was placed on the floor.  He vomited x1.  His breathing was slow and shallow and lips appeared to be blue.  EMS was called. He was awake, and alert and "appeared fine" when they arrived.  They transported him to Hospital.  He was admitted into ICU for observation.  Mother states final diagnosis was vasovagal reaction to injection.  He is fully recovered. 12/03/09 ED  and Hospital records received for DOS 11/11-11/12/09. Pt. presented with history of eyes rolling back in head, shallow breathing, vomiting at home 30 minutes after receiving vaccine.  Pallor, cyanosis noted while in ER. Admitted to pediatric ICU. Cardiology, Neurology consults obtained. DX: Possible vasovagal reaction
Age: 46.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Eye swelling, Feeling hot, Scleral discolouration
Clinical narrative: Felt warm; bilateral scleral redness and eye swelling. Treated with Benadryl with relief.
Age: 12.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Allergy to vaccine, Dizziness, Pallor
Clinical narrative: Room was very hot for mass H1N1 clinic in school. Patient waited in line prior to vaccination. Symptoms per school RN at 10:45AM- dizziness. Best friend of child taken via ambulance to ER after receiving vaccine also. Patient was pale, no diaphoresis or loss of consciousness at school. Discharged to mother at 11:27 AM-mother took child to ER. D/C from ER 4:32 PM. TC to mother 11-24-stated "child had severe allergic reaction to vaccine".
Age: 13.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Asthenia, Hyperhidrosis, Loss of consciousness, Nausea
Clinical narrative: Room was hot for mass H1N1 school clinic. Patient waited in line prior to vaccine. Symptoms were nausea - ice given. Sent to school nurse to lay down. Patient was weak diaphoretic with fading consciousness. Vital signs stable per school nurse. Parents notified and ambulance called as condition did not improve. Ammonia inhalant used. Ambulance arrived around 11:20 am.
Age: 54.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Antinuclear antibody, Areflexia, Asthenia, Blood bicarbonate normal, Blood calcium normal
Clinical narrative: 11/15/09 she came to the ER noting 2-3 days of gradually increasing weakness and numbness in her hands and feet which made ambulating difficult and in need of assistance. 11/15/2009 - 3 hours prior to arriving at the ER, pt mentioned that she had vomited and started to feel worse. 11/16/2009 - The patient seems very groggy. According to documentation, she has received several doses of DILAUDID overnight. Additionally, the patient has had an enterococcus UTI and Dr. of infectious disease has been following her. The patient was moved to the unit yesterday for concerns of worsening respiratory mechanics and weakness. Patient takes Dicyclomine, Atenolol, and Amitriptyline for Fibromyalgia and hypertension.  LODINE and PERCOCET were administered in ER. The plan is to continue Atenolol, decrease Amitriptyline to 25 mg at h.s giving small dose of Clonazepam in order to help the patient sleep. Will get negative inspiratory flows and vital capacities b.i.c. Medications in the hospital included Amitriptyline 25 mg po q.h.s., IV fluids, LOVENOX 40 mg subcu qd, ZOFRAN prn, LEVAQUIN 500 mg IV q24 h, Hydromorphone 2 mg q4h prn IV, Tizanidine 2 mg pot id, Clonazepam 1 mg po q h.s., Docusate Propoxyphene with acetaminophen 1 q4h prn, Atenolol 25 mg q a.m. immunoglobulin infusions. 11/19/2009 - The patient had a negative inspiratory force of -60 mm of mercury and a FEC or forced vital capacity of 20 liters. Possible LOVENOX DVT prophylaxis, physical therapy consultation, and if she does developed hypoxemia or her pressures worsen a possible arterial blood gas. Patient has some crackles in her left base and a chest X-ray is warranted. Monitor her q6 h FVC and MITH and MEPTH.
Age: 54.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Blood creatine phosphokinase, Blood electrolytes normal, Blood glucose increased, Blood glucose normal, Blood potassium increased
Clinical narrative: 11/15/09 she came to the ER noting 2-3 days of gradually increasing weakness and numbness in her hands and feet which made ambulating difficult and in need of assistance. 11/15/2009 - 3 hours prior to arriving at the ER, pt mentioned that she had vomited and started to feel worse. 11/16/2009 - The patient seems very groggy. According to documentation, she has received several doses of DILAUDID overnight. Additionally, the patient has had an enterococcus UTI and Dr. of infectious disease has been following her. The patient was moved to the unit yesterday for concerns of worsening respiratory mechanics and weakness. Patient takes Dicyclomine, Atenolol, and Amitriptyline for Fibromyalgia and hypertension.  LODINE and PERCOCET were administered in ER. The plan is to continue Atenolol, decrease Amitriptyline to 25 mg at h.s giving small dose of Clonazepam in order to help the patient sleep. Will get negative inspiratory flows and vital capacities b.i.c. Medications in the hospital included Amitriptyline 25 mg po q.h.s., IV fluids, LOVENOX 40 mg subcu qd, ZOFRAN prn, LEVAQUIN 500 mg IV q24 h, Hydromorphone 2 mg q4h prn IV, Tizanidine 2 mg pot id, Clonazepam 1 mg po q h.s., Docusate Propoxyphene with acetaminophen 1 q4h prn, Atenolol 25 mg q a.m. immunoglobulin infusions. 11/19/2009 - The patient had a negative inspiratory force of -60 mm of mercury and a FEC or forced vital capacity of 20 liters. Possible LOVENOX DVT prophylaxis, physical therapy consultation, and if she does developed hypoxemia or her pressures worsen a possible arterial blood gas. Patient has some crackles in her left base and a chest X-ray is warranted. Monitor her q6 h FVC and MITH and MEPTH.
Age: 54.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Blood product transfusion, C-reactive protein, CD4 lymphocytes, Condition aggravated, Crepitations
Clinical narrative: 11/15/09 she came to the ER noting 2-3 days of gradually increasing weakness and numbness in her hands and feet which made ambulating difficult and in need of assistance. 11/15/2009 - 3 hours prior to arriving at the ER, pt mentioned that she had vomited and started to feel worse. 11/16/2009 - The patient seems very groggy. According to documentation, she has received several doses of DILAUDID overnight. Additionally, the patient has had an enterococcus UTI and Dr. of infectious disease has been following her. The patient was moved to the unit yesterday for concerns of worsening respiratory mechanics and weakness. Patient takes Dicyclomine, Atenolol, and Amitriptyline for Fibromyalgia and hypertension.  LODINE and PERCOCET were administered in ER. The plan is to continue Atenolol, decrease Amitriptyline to 25 mg at h.s giving small dose of Clonazepam in order to help the patient sleep. Will get negative inspiratory flows and vital capacities b.i.c. Medications in the hospital included Amitriptyline 25 mg po q.h.s., IV fluids, LOVENOX 40 mg subcu qd, ZOFRAN prn, LEVAQUIN 500 mg IV q24 h, Hydromorphone 2 mg q4h prn IV, Tizanidine 2 mg pot id, Clonazepam 1 mg po q h.s., Docusate Propoxyphene with acetaminophen 1 q4h prn, Atenolol 25 mg q a.m. immunoglobulin infusions. 11/19/2009 - The patient had a negative inspiratory force of -60 mm of mercury and a FEC or forced vital capacity of 20 liters. Possible LOVENOX DVT prophylaxis, physical therapy consultation, and if she does developed hypoxemia or her pressures worsen a possible arterial blood gas. Patient has some crackles in her left base and a chest X-ray is warranted. Monitor her q6 h FVC and MITH and MEPTH.
Age: 54.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Culture urine positive, Gait disturbance, Haemoglobin normal, Hypoaesthesia, Hyporeflexia
Clinical narrative: 11/15/09 she came to the ER noting 2-3 days of gradually increasing weakness and numbness in her hands and feet which made ambulating difficult and in need of assistance. 11/15/2009 - 3 hours prior to arriving at the ER, pt mentioned that she had vomited and started to feel worse. 11/16/2009 - The patient seems very groggy. According to documentation, she has received several doses of DILAUDID overnight. Additionally, the patient has had an enterococcus UTI and Dr. of infectious disease has been following her. The patient was moved to the unit yesterday for concerns of worsening respiratory mechanics and weakness. Patient takes Dicyclomine, Atenolol, and Amitriptyline for Fibromyalgia and hypertension.  LODINE and PERCOCET were administered in ER. The plan is to continue Atenolol, decrease Amitriptyline to 25 mg at h.s giving small dose of Clonazepam in order to help the patient sleep. Will get negative inspiratory flows and vital capacities b.i.c. Medications in the hospital included Amitriptyline 25 mg po q.h.s., IV fluids, LOVENOX 40 mg subcu qd, ZOFRAN prn, LEVAQUIN 500 mg IV q24 h, Hydromorphone 2 mg q4h prn IV, Tizanidine 2 mg pot id, Clonazepam 1 mg po q h.s., Docusate Propoxyphene with acetaminophen 1 q4h prn, Atenolol 25 mg q a.m. immunoglobulin infusions. 11/19/2009 - The patient had a negative inspiratory force of -60 mm of mercury and a FEC or forced vital capacity of 20 liters. Possible LOVENOX DVT prophylaxis, physical therapy consultation, and if she does developed hypoxemia or her pressures worsen a possible arterial blood gas. Patient has some crackles in her left base and a chest X-ray is warranted. Monitor her q6 h FVC and MITH and MEPTH.
Age: 54.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Laboratory test normal, Lumbar puncture, Muscular weakness, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain normal
Clinical narrative: 11/15/09 she came to the ER noting 2-3 days of gradually increasing weakness and numbness in her hands and feet which made ambulating difficult and in need of assistance. 11/15/2009 - 3 hours prior to arriving at the ER, pt mentioned that she had vomited and started to feel worse. 11/16/2009 - The patient seems very groggy. According to documentation, she has received several doses of DILAUDID overnight. Additionally, the patient has had an enterococcus UTI and Dr. of infectious disease has been following her. The patient was moved to the unit yesterday for concerns of worsening respiratory mechanics and weakness. Patient takes Dicyclomine, Atenolol, and Amitriptyline for Fibromyalgia and hypertension.  LODINE and PERCOCET were administered in ER. The plan is to continue Atenolol, decrease Amitriptyline to 25 mg at h.s giving small dose of Clonazepam in order to help the patient sleep. Will get negative inspiratory flows and vital capacities b.i.c. Medications in the hospital included Amitriptyline 25 mg po q.h.s., IV fluids, LOVENOX 40 mg subcu qd, ZOFRAN prn, LEVAQUIN 500 mg IV q24 h, Hydromorphone 2 mg q4h prn IV, Tizanidine 2 mg pot id, Clonazepam 1 mg po q h.s., Docusate Propoxyphene with acetaminophen 1 q4h prn, Atenolol 25 mg q a.m. immunoglobulin infusions. 11/19/2009 - The patient had a negative inspiratory force of -60 mm of mercury and a FEC or forced vital capacity of 20 liters. Possible LOVENOX DVT prophylaxis, physical therapy consultation, and if she does developed hypoxemia or her pressures worsen a possible arterial blood gas. Patient has some crackles in her left base and a chest X-ray is warranted. Monitor her q6 h FVC and MITH and MEPTH.