Received Apr 1, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| DTAPIPV | DTAP + IPV (KINRIX) | GLAXOSMITHKLINE BIOLOGICALS | UNK | 5G23D | IM / LA |
| MMRV | MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) | MERCK & CO. INC. | UNK | Y017207 | SC / LA |
Patient is a 4 year old male with a past medical history of asthma presenting with left arm swelling s/p vaccines. Patient received his 4 year old vaccinations yesterday at 1000 (Dtap/IPV/MMR). He returned to school after vaccines with no issue or concerns from patient's school. Last evening, parents noted significant upper arm swelling, redness, and tenderness. Symptoms worsened over night and into this morning. He was in pain all night and was given tylenol without significant improvement. Reportedly waking up every 30 mins. Dad became concerned when patient stopped using his left arm today, which prompted him to come to ED. Of note, parents report a similar reaction after vaccines when patient was around 1 year old. However, dad notes the reaction was more localized that time and resolved without antibiotics. Patient had 1 reported low grade temp (around 100F), for which he received tylenol. No recent falls or trauma to left arm. No past skin or soft tissue infection. Family has a 2-year old cat at home but deny concern for recent scratch or bite. No known bug bites prior to onset of symptoms. No recent travel. Denies rash, cough, congestion, swollen lymph nodes, decrease PO intake or UOP, AMS, lethargy. Routine immunizations up to date. Older brother and sister at home, no recent sick contacts.
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