Received Jun 2, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| MMR | MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 1 | Y 014095 | SC / LL |
On 4/27/25, patient and her mom were on a plane in (redacted state) about to return to (redacted state). Mom noticed patient suddenly became lethargic with rightward gaze deviation, clonic movement of R arm, which spread to involve her full body. EMS gave two doses Versed with cessation of seizure for total duration of 20 minutes. She had a temp of 101.7F at that time. At Hospital, had L arm clonic movement, leftward gaze and intermittent twitching. Received two doses of IV lorazepam and Keppra bolus, was intubated and started on Versed drip. She was transferred to another level of care Hospital and admitted to the PICU. Started on Keppra, had continuous video EGG without seizure activity. She remained intubated for brain MRI, which was reassuring, then extubated and weaned to room air. Transitioned from Keppra to Klonopin by discharge. Received IV ceftriaxone, vancomycin and acyclovir while blood, urine and CSF studies were pending. She had mostly returned to baseline neurologic status by discharge on 4/30/25. She has since followed up with Pediatric Neurology on 5/12/25. She had an EEG on 5/7/25 that was normal for her age.
Office visit 4/9/25 for fever and URI symptoms, found to have bilateral AOM on exam, started on Augmentin BID for 10 days. She had bilateral AOM diagnosed 3/21/25 and was treated with amoxicillin.
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Augmentin, 396 mg (45 mg/kg) BID for 10 days
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Blood, urine and CSF cultures showed no growth Viral respiratory panel positive for Coronavirus HKU1 NAT Head CT negative for intracranial abnormalities Video EEG from 4/28/25: "EEG Impression: This continuous EEG with audiovisual aids was within the broad limits of normal for age with excessive beta activity and definitely attributable to medication effect specifically midazolam, levetiracetam and less likely Precedex. There were neither focal nor generalized epileptiform discharges, there were no subclinical/electrographic seizures." Brain MRI from 4/28/25 showed "1. Normal MRI evidence of acute intracranial process. 2. Symmetric T2/T2 FLAIR hyperintense subcortical and peri atrial terminal myelination zones within the cerebral hemispheres, within normal developmental limits for age. No definite focal brain parenchymal abnormality is evident; otherwise unremarkable MRI of the brain. Follow up with MRI at or after 2 years of age may be helpful for further evaluation as clinically warranted. 3. Bilateral mastoid effusions, right larger than left. Enlarged adenoids and palatine tonsils, likely reactive/developmental, with nasopharyngeal narrowing, which may be associated with impaired Eustachian tube drainage and/or obstructive sleep apnea in the proper clinical setting. "