chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 39.0
Sex: F
Vaccine: FLU(H1N1), FLU(H1N1)
Symptoms: Activities of daily living impaired, Asthenia, Computerised tomogram, Dysarthria, Electroencephalogram
Clinical narrative: 11/13/09 "felt exhausted" approx 2 hours post vaccination.  11/14/09 Able to work around house but extremely tired - early to be 11/15/09 Awake ~0900 drank coffee, then back to sleep, Aroused for dinner, then back to bed. 11/16/09 Up at 0500. To work at 0700, noticed slurred speech and exhaustion left work at 1400 to go home to bed. 11/17/09 Aroused at 0500.  "Too weak to go to work"  Requested coffee from housemate.  Within 10 minutes back to sleep and unable to remember calling work.  Phone checked by housemate.  Patient did call work, but also tried to call a relative and misdialed the number. Fine rash noted on Face. Slurred speech, urinary incontinence, mispelled words, stumbling noted by roommate. 11/17/09 pm taken to ED where she was admitted to ICU following. 11/18/09 Transferred to another Medical Center ICU. 11/23/09 Medical records received for DOS 11/17/09- Final DX: Altered mental status, confusion, UTI, dehydration, encephalitis  C/O extreme somnolence S/P vaccine. Incontinence x1. Confusion. Unsteady gait.   L sided weakness. Head CT and CXR WNL. CMP WNL.   12/4/2009 MR and DC summary for 11/18-11/24/2009. Patient with c/o's fatigue, excessive sleep, mental confusion, urinary incontinence, LUE and LLE weakness and slurred speech. Neuro exam + for weakness lt side. Tx: initially with IV depakote which was changed to trazadone due to side effects, ABX for UTI, LP with S/P headache which was not relieved per blood patch, PT and OT Dc Dx: Complex migraine, UTI, Post LP headache    12/4/2009 MR and DC summary for 11/25-11/27/2009. Patient with c/o's seizure-like activity and continued LUE and LLE weakness. DC Dx: Probable pseudo-seizures vs conversion disorder, LUE and LLE weakness  12/8/2009 MR, H&P and Admission note for 11/18/2009 12/11/2009 PCP visit for 12/1/2009, f/up visit , neuro exam still notes decreased strength RUE, RLE and LLE, mild lt foot drop. referred to PT/OT, has f/up appt with Neurologist. Dx post vaccine encephalitis vs MS  12/23, 24 and 12/28/2009 Neurology f/up visit post hospitalization, patient currently on Keppra but having c/o's increased somnolence, confusion and headaches, denies any new seizure activity. Dc'd Keppra and started on Lamictal XL, to f/up in 2 months unless new problems
Age: 39.0
Sex: F
Vaccine: FLU(H1N1), FLU(H1N1)
Symptoms: Fatigue, Gait disturbance, Impaired work ability, Intensive care, Lumbar puncture
Clinical narrative: 11/13/09 "felt exhausted" approx 2 hours post vaccination.  11/14/09 Able to work around house but extremely tired - early to be 11/15/09 Awake ~0900 drank coffee, then back to sleep, Aroused for dinner, then back to bed. 11/16/09 Up at 0500. To work at 0700, noticed slurred speech and exhaustion left work at 1400 to go home to bed. 11/17/09 Aroused at 0500.  "Too weak to go to work"  Requested coffee from housemate.  Within 10 minutes back to sleep and unable to remember calling work.  Phone checked by housemate.  Patient did call work, but also tried to call a relative and misdialed the number. Fine rash noted on Face. Slurred speech, urinary incontinence, mispelled words, stumbling noted by roommate. 11/17/09 pm taken to ED where she was admitted to ICU following. 11/18/09 Transferred to another Medical Center ICU. 11/23/09 Medical records received for DOS 11/17/09- Final DX: Altered mental status, confusion, UTI, dehydration, encephalitis  C/O extreme somnolence S/P vaccine. Incontinence x1. Confusion. Unsteady gait.   L sided weakness. Head CT and CXR WNL. CMP WNL.   12/4/2009 MR and DC summary for 11/18-11/24/2009. Patient with c/o's fatigue, excessive sleep, mental confusion, urinary incontinence, LUE and LLE weakness and slurred speech. Neuro exam + for weakness lt side. Tx: initially with IV depakote which was changed to trazadone due to side effects, ABX for UTI, LP with S/P headache which was not relieved per blood patch, PT and OT Dc Dx: Complex migraine, UTI, Post LP headache    12/4/2009 MR and DC summary for 11/25-11/27/2009. Patient with c/o's seizure-like activity and continued LUE and LLE weakness. DC Dx: Probable pseudo-seizures vs conversion disorder, LUE and LLE weakness  12/8/2009 MR, H&P and Admission note for 11/18/2009 12/11/2009 PCP visit for 12/1/2009, f/up visit , neuro exam still notes decreased strength RUE, RLE and LLE, mild lt foot drop. referred to PT/OT, has f/up appt with Neurologist. Dx post vaccine encephalitis vs MS  12/23, 24 and 12/28/2009 Neurology f/up visit post hospitalization, patient currently on Keppra but having c/o's increased somnolence, confusion and headaches, denies any new seizure activity. Dc'd Keppra and started on Lamictal XL, to f/up in 2 months unless new problems
Age: 39.0
Sex: F
Vaccine: FLU(H1N1), FLU(H1N1)
Symptoms: Memory impairment, Rash, Urinary incontinence
Clinical narrative: 11/13/09 "felt exhausted" approx 2 hours post vaccination.  11/14/09 Able to work around house but extremely tired - early to be 11/15/09 Awake ~0900 drank coffee, then back to sleep, Aroused for dinner, then back to bed. 11/16/09 Up at 0500. To work at 0700, noticed slurred speech and exhaustion left work at 1400 to go home to bed. 11/17/09 Aroused at 0500.  "Too weak to go to work"  Requested coffee from housemate.  Within 10 minutes back to sleep and unable to remember calling work.  Phone checked by housemate.  Patient did call work, but also tried to call a relative and misdialed the number. Fine rash noted on Face. Slurred speech, urinary incontinence, mispelled words, stumbling noted by roommate. 11/17/09 pm taken to ED where she was admitted to ICU following. 11/18/09 Transferred to another Medical Center ICU. 11/23/09 Medical records received for DOS 11/17/09- Final DX: Altered mental status, confusion, UTI, dehydration, encephalitis  C/O extreme somnolence S/P vaccine. Incontinence x1. Confusion. Unsteady gait.   L sided weakness. Head CT and CXR WNL. CMP WNL.   12/4/2009 MR and DC summary for 11/18-11/24/2009. Patient with c/o's fatigue, excessive sleep, mental confusion, urinary incontinence, LUE and LLE weakness and slurred speech. Neuro exam + for weakness lt side. Tx: initially with IV depakote which was changed to trazadone due to side effects, ABX for UTI, LP with S/P headache which was not relieved per blood patch, PT and OT Dc Dx: Complex migraine, UTI, Post LP headache    12/4/2009 MR and DC summary for 11/25-11/27/2009. Patient with c/o's seizure-like activity and continued LUE and LLE weakness. DC Dx: Probable pseudo-seizures vs conversion disorder, LUE and LLE weakness  12/8/2009 MR, H&P and Admission note for 11/18/2009 12/11/2009 PCP visit for 12/1/2009, f/up visit , neuro exam still notes decreased strength RUE, RLE and LLE, mild lt foot drop. referred to PT/OT, has f/up appt with Neurologist. Dx post vaccine encephalitis vs MS  12/23, 24 and 12/28/2009 Neurology f/up visit post hospitalization, patient currently on Keppra but having c/o's increased somnolence, confusion and headaches, denies any new seizure activity. Dc'd Keppra and started on Lamictal XL, to f/up in 2 months unless new problems
Age: 39.0
Sex: F
Vaccine: FLU(H1N1), FLU(H1N1)
Symptoms: Computerised tomogram, Electrocardiogram, Electroencephalogram, Impaired work ability, Laboratory test
Clinical narrative: 11/13/09 "felt exhausted" approx 2 hours post vaccination.  11/14/09 Able to work around house but extremely tired - early to be 11/15/09 Awake ~0900 drank coffee, then back to sleep, Aroused for dinner, then back to bed. 11/16/09 Up at 0500. To work at 0700, noticed slurred speech and exhaustion left work at 1400 to go home to bed. 11/17/09 Aroused at 0500.  "Too weak to go to work"  Requested coffee from housemate.  Within 10 minutes back to sleep and unable to remember calling work.  Phone checked by housemate.  Patient did call work, but also tried to call a relative and misdialed the number. Fine rash noted on Face. Slurred speech, urinary incontinence, mispelled words, stumbling noted by roommate. 11/17/09 pm taken to ED where she was admitted to ICU following. 11/18/09 Transferred to another Medical Center ICU. 11/23/09 Medical records received for DOS 11/17/09- Final DX: Altered mental status, confusion, UTI, dehydration, encephalitis  C/O extreme somnolence S/P vaccine. Incontinence x1. Confusion. Unsteady gait.   L sided weakness. Head CT and CXR WNL. CMP WNL.   12/4/2009 MR and DC summary for 11/18-11/24/2009. Patient with c/o's fatigue, excessive sleep, mental confusion, urinary incontinence, LUE and LLE weakness and slurred speech. Neuro exam + for weakness lt side. Tx: initially with IV depakote which was changed to trazadone due to side effects, ABX for UTI, LP with S/P headache which was not relieved per blood patch, PT and OT Dc Dx: Complex migraine, UTI, Post LP headache    12/4/2009 MR and DC summary for 11/25-11/27/2009. Patient with c/o's seizure-like activity and continued LUE and LLE weakness. DC Dx: Probable pseudo-seizures vs conversion disorder, LUE and LLE weakness  12/8/2009 MR, H&P and Admission note for 11/18/2009 12/11/2009 PCP visit for 12/1/2009, f/up visit , neuro exam still notes decreased strength RUE, RLE and LLE, mild lt foot drop. referred to PT/OT, has f/up appt with Neurologist. Dx post vaccine encephalitis vs MS  12/23, 24 and 12/28/2009 Neurology f/up visit post hospitalization, patient currently on Keppra but having c/o's increased somnolence, confusion and headaches, denies any new seizure activity. Dc'd Keppra and started on Lamictal XL, to f/up in 2 months unless new problems
Age: 39.0
Sex: F
Vaccine: FLU(H1N1), FLU(H1N1)
Symptoms: Lethargy, Lumbar puncture, Nuclear magnetic resonance imaging, Somnolence
Clinical narrative: 11/13/09 "felt exhausted" approx 2 hours post vaccination.  11/14/09 Able to work around house but extremely tired - early to be 11/15/09 Awake ~0900 drank coffee, then back to sleep, Aroused for dinner, then back to bed. 11/16/09 Up at 0500. To work at 0700, noticed slurred speech and exhaustion left work at 1400 to go home to bed. 11/17/09 Aroused at 0500.  "Too weak to go to work"  Requested coffee from housemate.  Within 10 minutes back to sleep and unable to remember calling work.  Phone checked by housemate.  Patient did call work, but also tried to call a relative and misdialed the number. Fine rash noted on Face. Slurred speech, urinary incontinence, mispelled words, stumbling noted by roommate. 11/17/09 pm taken to ED where she was admitted to ICU following. 11/18/09 Transferred to another Medical Center ICU. 11/23/09 Medical records received for DOS 11/17/09- Final DX: Altered mental status, confusion, UTI, dehydration, encephalitis  C/O extreme somnolence S/P vaccine. Incontinence x1. Confusion. Unsteady gait.   L sided weakness. Head CT and CXR WNL. CMP WNL.   12/4/2009 MR and DC summary for 11/18-11/24/2009. Patient with c/o's fatigue, excessive sleep, mental confusion, urinary incontinence, LUE and LLE weakness and slurred speech. Neuro exam + for weakness lt side. Tx: initially with IV depakote which was changed to trazadone due to side effects, ABX for UTI, LP with S/P headache which was not relieved per blood patch, PT and OT Dc Dx: Complex migraine, UTI, Post LP headache    12/4/2009 MR and DC summary for 11/25-11/27/2009. Patient with c/o's seizure-like activity and continued LUE and LLE weakness. DC Dx: Probable pseudo-seizures vs conversion disorder, LUE and LLE weakness  12/8/2009 MR, H&P and Admission note for 11/18/2009 12/11/2009 PCP visit for 12/1/2009, f/up visit , neuro exam still notes decreased strength RUE, RLE and LLE, mild lt foot drop. referred to PT/OT, has f/up appt with Neurologist. Dx post vaccine encephalitis vs MS  12/23, 24 and 12/28/2009 Neurology f/up visit post hospitalization, patient currently on Keppra but having c/o's increased somnolence, confusion and headaches, denies any new seizure activity. Dc'd Keppra and started on Lamictal XL, to f/up in 2 months unless new problems
Age: 8.0
Sex: F
Vaccine: FLUX, IPV
Symptoms: Aggression, Amnesia, Appetite disorder, Mood swings, Regressive behaviour
Clinical narrative: Agression, severe mood swings, memory loss (developemental regression), complete change in appetite, weight loss, speech regression.
Age: 8.0
Sex: F
Vaccine: FLUX, IPV
Symptoms: Speech disorder, Weight decreased
Clinical narrative: Agression, severe mood swings, memory loss (developemental regression), complete change in appetite, weight loss, speech regression.
Age: 50.0
Sex: F
Vaccine: FLUX(H1N1)
Symptoms: Injection site pain
Clinical narrative: When my arm was penetrated it hurt.
Age: 27.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Drug exposure during pregnancy
Clinical narrative: None, Pt discovered she was pregnant after receiving the H1N1 nasal mist.
Age: 55.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Blood pressure increased, Burning sensation, Headache, Musculoskeletal stiffness, Neck pain
Clinical narrative: Headache, facial burning (left side), stiff and painful neck, slight burning in throat, and elevated blood pressure.
Age: 55.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Throat irritation
Clinical narrative: Headache, facial burning (left side), stiff and painful neck, slight burning in throat, and elevated blood pressure.
Age: 0.87
Sex: F
Vaccine: DTAP, HIBV, IPV, PPV, RV5
Symptoms: Apparent life threatening event, Blood culture, Body temperature increased, Chest X-ray normal, Crying
Clinical narrative: 4 month old diagnosis Apparent life threatening event. 8 hrs s/p vaccine administration. Per mom, infant with pallor, cyanosis x  few seconds after nap. Hosp x 1 day.
Age: 0.87
Sex: F
Vaccine: DTAP, HIBV, IPV, PPV, RV5
Symptoms: Culture urine, Cyanosis, Electrocardiogram normal, Eyelid disorder, Full blood count
Clinical narrative: 4 month old diagnosis Apparent life threatening event. 8 hrs s/p vaccine administration. Per mom, infant with pallor, cyanosis x  few seconds after nap. Hosp x 1 day.
Age: 0.87
Sex: F
Vaccine: DTAP, HIBV, IPV, PPV, RV5
Symptoms: Hypotonia, Influenza serology negative, Irritability postvaccinal, Laboratory test, Neutrophil count increased
Clinical narrative: 4 month old diagnosis Apparent life threatening event. 8 hrs s/p vaccine administration. Per mom, infant with pallor, cyanosis x  few seconds after nap. Hosp x 1 day.
Age: 0.87
Sex: F
Vaccine: DTAP, HIBV, IPV, PPV, RV5
Symptoms: Pallor, Pertussis identification test positive, Petechiae, Platelet count increased, Pulmonary function test decreased
Clinical narrative: 4 month old diagnosis Apparent life threatening event. 8 hrs s/p vaccine administration. Per mom, infant with pallor, cyanosis x  few seconds after nap. Hosp x 1 day.
Age: 0.87
Sex: F
Vaccine: DTAP, HIBV, IPV, PPV, RV5
Symptoms: Respiratory syncytial virus test negative, Urine analysis normal, White blood cell count increased
Clinical narrative: 4 month old diagnosis Apparent life threatening event. 8 hrs s/p vaccine administration. Per mom, infant with pallor, cyanosis x  few seconds after nap. Hosp x 1 day.
Age: 0.2
Sex: M
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Anal fissure, Diarrhoea, Faeces discoloured, Haematochezia
Clinical narrative: Information received on 10 November 2009 from another manufacturer (report number WAES 0910USA02799). "Information has been received from an office manager concerning a 57 day old male patient with no known drug reactions/allergies or pertinent medical history who on 07-OCT-2009 was orally vaccinated with his first dose of ROTATEQ (Lot # 663903/0088Y). There was no concomitant medication. The office manager mentioned that on 07-OCT-2009, the patient received ROTATEQ and developed diarrhea. On 14-OCT-2009 the patient sought medical attention by an office visit and the physician wrote in her office notes "patient had been stooling for 6-7 days, stools greenish at times, and a few drops of blood noted. Child has been acting well at home". No lab tests were performed. It was reported that when the child was seen the frequency of the stools had begun to resolve. The physician prescribed "baby acidophilus" and the mother was told to call if he did not improve. It was noted that the office had not received any additional calls from the mother. At the time of the report, the patient had recovered." "Follow-up information has been received from the office manager via telephone call regarding the patient who on 07-OCT-2009 was vaccinated with ROTATEQ also received PENTACEL (Lot # C3385AA), PREVNAR (Lot # D575886) and hepatitis B virus vaccine (unspecified) (Manufacturer Unknown) (Lot # 1102Y). The office manager reported that the patient did not experience hematochezia, rather there were a few drops of blood from an anal fissure noted at the 14-OCT-2009 office visit and Neosporin was ordered as treatment. Upon internal review, a few drops of blood in the stool was determined to be an other important medical event. Additional information is not expected."
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Antibody test negative, Bacterial test negative, Blood glucose increased, Blood immunoglobulin G normal, Blood immunoglobulin M increased
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Borrelia burgdorferi serology negative, Brucella serology negative, CSF cell count increased, CSF culture negative, CSF glucose normal
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: CSF immunoglobulin increased, CSF lymphocyte count normal, CSF monocyte count decreased, CSF myelin basic protein increased, CSF neutrophil count increased
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: CSF protein increased, CSF white blood cell count increased, Cerebellar syndrome, Cryptococcus antigen, Cytomegalovirus test negative
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Enterovirus serology test negative, Epstein-Barr virus test negative, HIV antibody negative, Headache, Herpes simplex serology negative
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Human herpes virus 6 serology negative, Hyperaesthesia, Hyperreflexia, Lymphocyte percentage increased, Monocyte percentage increased
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Muscular weakness, Mycobacteria test, Mycoplasma serology, Nausea, Nervous system disorder
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Neutrophil percentage decreased, Nuchal rigidity, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain abnormal, Nuclear magnetic resonance imaging spinal cord abnormal
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Nystagmus, Paraesthesia, Paraparesis, Parasite blood test, Photophobia
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Pyrexia, Red blood cells CSF positive, Rickettsia antibody, Sensory level abnormal, Spinal cord disorder
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.
Age: 23.0
Sex: M
Vaccine: YF
Symptoms: Syphilis test, Urinary retention, Varicella zoster serology negative, Viral test negative, Vomiting
Clinical narrative: Literature report from foreign country on 26 October 2009. Case report: "A 23-year-old previously healthy man received immunization against yellow fever (17-D-204) 2 weeks prior to foreign travel. Three weeks later, he developed fever, nausea, vomiting, severe bifrontal headaches and photophobia, followed by ascending weakness of the lower limbs, paresthesias of his feet, and urinary retention. On examination, he was febrile, had mild nuchal rigidity, and exhibited unsustained horizontal nystagmus on left gaze, discrete left arm dysmetria, bilateral symmetric lower extremity paresis, patellar and ankle hyperreflexia, and impaired sensation to light-touch and pinpick with an ill defined sensory level around T9. Magnetic resonance imaging (MRI) of the brain and spinal cord showed areas of high signal intensity on T2 weighted and fluid attenuation inversion recovery (FLAIR) in the middle cerebellar penduncle, right dorsal medulla oblongata and a multilevel lesion involving the thoracic spinal cord with subtle patchy heterogeneous enhancement after administration of gadolinium. Cerebrospinal fluid (CSF) analysis showed clear and colorless fluid with a normal opening pressure. Cell count was elevated with 62 white blood cells (neutrophils 41%, lymphocytes 46%, monocytes 13%) 17 red blood cells, glucose 54 mg/100mL (serum glucose 154 mg/100mL) and a protein content of 105 mg/dL. CSF cultures were negative. Serum and CSF evaluations for herpes simples virus type 1 and 2, epstein barr virus, varicella zoster virus, cytomegalovirus, human herpes virus type 6, enterovirus, human deficiency virus, human T-lymphocytic virus 1 and 2, rabies virus, arbovirus barthonella quintana, rickettsiae, brucella spp, leptospiras, salmonella, borrelias, myobacterias, treponema pallidum, plasmodium, cryptococcus and myoplasma were negative. CSF myelin basic protein (MBP) was elevated with a level of 618 ng/mL. CSF total IgG level, and IgG index were normal. CSF specific IgM antibodies to YEL levels were elevated with a level of 15.6, IgM and IgG specific antibodies to YEL levels in serum were 4.8 and 1.4 respectively (normal is less than 2.0). The patient received a five-day course of 1 gram daily of intravenous methylprednisolone, with marked clinical improvement. MRI of brain and entire spine showed resolution of previous lesions 30 days after initiation of therapy." Follow-up information received 09 November 2009 from a co-author of the above mentioned literature report. The reporter confirmed that the patient had been vaccinated in another country. The vaccine administered was YF VAX (lot number not provided). No additional information was provided.