VAERS ID: 198972

AGE: 22| SEX: M|STATE: CA (United States)

Description

SMALLPOX LESIONS ON BACK. PATIENT WAS TREATED AS AN OUTPATIENT01/27/03 WITH AMOXICILLIAN PO 250 MG #30, DECONAMINE SR #20 AND TYLENOL 325MG. PATIENT DID NOT RESPONDE TO TREATMENT. ON /2/21/03 PATIENT WAS TX'D AGAIN WITH CEPHALEXIN PO 500 MG #40 AND HYDROXYZINE HCL PO 25 MG #20. PT WAS ADMITTED TO NHCP ON 2/22/03 AND WAS TREATED WITH NAFACILLIN 2 GM IM AND WAS REFERRED TO DERMATOLOGY.

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Symptoms

Dermatitis bullous

Vaccines

VAX DATE: 02-10-2003| ONSET DATE: 02-22-2003| DAYS TO ONSET: 12
NameDose #TypeManufacturerLotRouteSite
SMALLPOX (DRYVAX) 1 SMALL PFIZER\WYETH 4020071 ID Unknown

RECVDATE:03-06-2003
RPT_DATE:03-06-2003
CAGE_YR:22
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:Y
HOSPDAYS:3
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:LABS: BLOOD CX-NO GROWTH AFTER 5 DAYS. WBW W/ DIFF WNL EXCEPT MONO % CELLS 1.70 AND mono % 19.5. ESR 20.
V_ADMINBY:MIL
OTHER_MEDS:01/03/2003 ALUMINUM ACETATE PACKET
CUR_ILL:UNKNOWN
HISTORY:UNKNOWN
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:1
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:MIL

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