Received May 2, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| MMRV | MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) | MERCK & CO. INC. | 1 | Y012341 | SC / LA |
Below is statement from emergency room report : " Medical Decision Making 4 yo previously healthy fully vaccinated F who presents with 2 days of blisters and erythema, induration, and warmth to left upper extremity following vaccine administration. On exam, she has nearly circumferential erythema of the left upper extremity with area of induration and few blisters, 1 of which has been denuded, the entire area warm to touch. Overall most consistent with cellulitis. -Considered abscess but lack of fluctuance points against. -Considered sepsis/bacteremia but well appearance, lack of fever, normal perfusion and MS point against. -Considered compartment syndrome given near circumferential nature of cellulitis but compartments still soft, nvi. -Considered MRSA but no h/o such and no fhx recurrent boils. -Considered anaphylaxis but isolated rash to distinct area of arm with no other s/s points against. -Considered varicella or measles given recent vaccine administration but distribution and appearance are not consistent with either rash. Labs were considered but not performed given low suspicion for sepsis/bacteremia and no GI sx to suggest electrolyte abnormality, so these were thought to not change clinical management. Imaging (US soft tissue) was considered but not performed given low suspicion for abscess at this time. Reassured family of low concern for reaction or allergy to vaccine contents given localized distribution, no signs of anaphylaxis. Plan: - Given allergy to Keflex, will prescribe clindamycin for 5-day course per IDMP. First Dose given in ED. - Borders of erythema drawn with pen -May give Tylenol or ibuprofen for discomfort or fever -Strict return precautions discussed, including worsening erythema outside the borders of the outline, pain, induration, fever despite antibiotics. Family agreeable with plan, all questions answered"
None.
N/A
Cephalexin - Peri-oral rash and swelling and systemic rash.