This spontaneous report as received from the patient's mother in an article online via a company representative, refers to a 11 year old female patient who was normal, conscientious, healthy and very active. The patient's medical history was not reported. On 02-SEP-2010, the patient was vaccinated with her first dose of GARDASIL (dose, lot number and route not provided). No co-suspect or concomitant therapies were provided. The patient's mother stated that on 07-SEP-2010 was the patient's first day of middle school and approximately in September 2010, after receiving GARDASIL, the patient began to experience fatigue and headaches. The patient did not feel good. She began sleeping over 12 hours a day and even more on the weekends. She missed days at school, dance lessons and cheer practices. Soon, her illness was visible on the outside too. She did not look good, she had circles under her eyes, her skin color was ashen and she appeared listless. Approximately in September 2010, the patient's earliest symptoms were a constant headache or migraine that did not respond to pain relievers, stabbing 24/7 bilateral ear pain, fatigue not relieved by sleep, abdominal pain, nausea and joint pain. The patient visited her pediatrician repeatedly, and began visiting neurologists, ear, nose and throat specialist (ENT's), gastroenterologists (GI), and an obstetrics and gynecology (OBGYN) specialist, and made several visits to the Emergency Room. The patient received many blood tests, computerized tomogram (CAT) scans and a magnetic resonance imaging (MRI), but there was no relief of the patient's symptoms. The reporter stated that the drugs prescribed to alleviate her symptoms only made her feel worse. The patient's pediatrician and other doctors involved with the patient care began suggesting that her illness was psychosomatic and recommended to take her to a psychologist. In October 2010, the patient was first tested for Lyme disease and the results were negative (as were two later rounds of testing, exact dates unspecified). In April 2011, the patient could no longer go to school or participate in dance or cheerleading because the pain and fatigue were all consuming. The reporter stated that there was no relief of the patient's symptoms and every doctor refused to consider Lyme disease or GARDASIL to be related to the patient's illness. In approximately April 2011, the patient's list of symptoms included the following: 24/7 headaches and migraines, 24/7 stabbing ear pain, hyperacusis, fatigue, abdominal pain, nausea, all over joint pain, constant sore throat, visual disturbances, light sensitivity, cognitive issues such as memory and severe comprehension problems, random numbness and tingling, weird "bug crawling" skin sensations, generalized weakness throughout her body (it was difficult for the patient to just sit in the shower to bathe), dizziness, fainting and heart palpitations. The patient slept long hours and stayed in her bedroom shielding herself from the noise of everyday living. In May 2011, tick-borne specialized lab tests were performed. The results showed that the patient was highly positive for Bartonella henselae, also highly positive for Mycoplasma pneumoniae and that her immune system was struggling. The patient's Western Blot for Lyme disease was negative. The reporter mentioned that the results were taken to the local hospital and also to the patient's neurologist, and even the patient had the classic Bartonella rash (looked like purple and red stretch marks) surrounding her breasts and hips which was confirmation of an active Bartonella infection, both doctors told her that these test results only showed that the patient was "exposed" to Bartonella but it did not mean she had an active infection. and that both came to the same conclusion that her Bartonella rash was actually just stretch marks. The reporter stated that neither doctor was concerned about the patient's blazing Mycoplasma pneumoniae infection nor was the fact that the testing showed her immune system impaired. Instead, the hospital diagnostic center diagnosed the patient with the beginning stages of dysautonomia with no cure and with symptoms to be managed with medications. The hospital neurologist was not in agreement with the diagnostic center and diagnosed Chronic Migraine Disorder with Chronic Ear Pain Neuralgia. The neurologist recommended to continue with the same treatment of "20 pills a day" even though it did not improve the patient's symptoms but increased her nausea and head pain. In June 2011, after nine months, the patient visited a Lyme Literate Medical Doctor (LLMD) who review her blood tests and other medical reports, and then clinically diagnosed her with Lyme disease, and agreed with the test results that reported active infections with Bartonella Henselae and Mycoplasma pneumoniae. The physician said the patient was very sick and acknowledged she was ill. Since that time, the patient was diagnosed with chronic Strep, human herpes virus 6 (HHV6), hypocoagulation, susceptibility to biotoxin illness (mold and environmental sensitivities) and had acquired autoimmune thyroid disease. The reporter stated that the patient was still chronically ill, she was unable to attend school in 7th and 8th grades, and she decided to repeat 8th grade again rather than begin high school still sick. The patient had a plan in school to reduce her daily schedule, she was still too sick to attend school with any regularity. Most days, a teacher went to her home to review the lessons she missed at school. Some days, the patient's pain levels were too high so that she could not even tolerate home tutoring. Most days, the patient remained at her room sleeping and trying to cope with chronic pain. The reporter also stated that the LLMD and the patient's Primary Care Physician reviewed the patient's vaccine log and extensive medical records and both agreed that the patient's immune system was injured by GARDASIL and that it was the catalyst to her cascading health problems and chronic illness. The patient's LLMD was still treating her for a vaccine injury in addition to treating multiple tick-borne diseases, other infections/viruses and autoimmune thyroid disease. At the time of the report, the outcomes of the events Cat scratch disease, mycoplasma infection, immune system disorder, ear pain, pain, somnolence, neuralgia, autonomic nervous system imbalance, migraine, malaise, fatigue, and asthenia were assessed as not recovered/not resolved .The outcome for the other reported events was unknown. The reporter considered the all the reported events to be related to GARDASIL. Upon internal review, the events Cat scratch disease, mycoplasma infection, and Lyme disease were considered to be disabling because the patient was unable to attend school in 7th and 8th grades and was still too sick to attend school with any regularity. This case in linked to case MARRS# 1503USA015062 (same reporter link). Additional information is not expected because the reporter details were not provided.