Report #2831210

Received Mar 13, 2025

ER / ED visitOffice visit

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Overview

Sex: Female
Age: 4 yrs
State: CA
Recovered: Recovered
Vaccinated: Mar 10, 2025
Onset: Mar 10, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
MMRV	MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)	MERCK & CO. INC.	2	Y009344	IM / LL

Symptoms (1)

Angioedema

Symptom narrative

angioedema

Current illness

"Had fever, cough, runny nose about a month ago"

Medical history

hyperphenylalaninemia

Other medications

Clartin daily.

Allergies

Soy , Wheat, Cats, latex. Of note pt ate Burger with wheat bun, fries and strawberry milkshake (with soy) after injection.

Lab data

Pt pending for allergiest