Received Jun 5, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| DTPPVHBHPB | DTAP+IPV+HIB+HEPB (VAXELIS) | MSP VACCINE COMPANY | 3 | U7623AA | IM / LL |
| PNC20 | PNEUMO (PREVNAR20) | PFIZER\WYETH | 2 | LN4929 | RL |
| RV5 | ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | 3 | 2052023 | PO / MO |
Chief Complaint Vomiting yellow-green bile for over 1.5 hours yesterday, lethargy, pallor, dehydration requiring ER visit and IV fluids History of Present Illness Patient, an infant male with a recent history of adenovirus and parainfluenza 3 in early May, presents for follow-up after an emergency room visit and hospitalization due to acute vomiting and lethargy. Yesterday, around 2:30 PM, while napping in his swing, patient began vomiting. The vomiting episodes occurred every 1-2 minutes, progressing from what appeared to be a mix of spit-up and vomit to yellow-green bile. The episodes continued until after 4 PM. Accompanying symptoms included pallor, lethargy, and refusal to nurse. Patient's mother reports he became pale, with his lips losing color, and he didn't smile. He was gagging, whimpering, and dry-heaving, with his face turning red during episodes. His grandmother noted he looked gray. Due to the severity of symptoms, patient was taken to the emergency room where he received IV fluids, labs, and imaging studies. The ER pediatrician initially suspected a possible partial intussusception based on x-ray findings. Patient was transferred by ambulance to another hospital for further evaluation, where repeat scans were normal. He regained his color by 9 PM and stopped vomiting after 7 PM. He received IV fluids and was able to nurse before being discharged with instructions to follow up with the pediatrician. Since discharge, patient has been tired but nursing normally. He hasn't had any solid foods. This morning at 11 AM, he had light brown diarrhea. The mother notes that patient had a slight fever from shots on Friday, but has no fever now. She also mentions that his stool on Saturday night was mucousy, which she attributes to the rotavirus vaccine. Today, patient appears pale with some nasal contractions. The mother reports that patient had adenovirus and parainfluenza 3 in early May, which caused yellow diarrhea. She states he hasn't had any bloody or mucousy stools indicative of intussusception. The mother mentions that patient had avocado yesterday morning, which she suspects might be linked to his symptoms. Medical History - Emergency room visit and hospitalization for severe vomiting and dehydration - Adenovirus and parainfluenza 3 infections in early May - Vaccinations received, including rotavirus vaccine Medications and Supplements - Rotavirus vaccine - Administered Friday - Side effect: Mucousy poop on Saturday night Social History - Living Situation: Lives with parents - Diet: Exclusively breastfed, no solid foods introduced yet except for recent avocado trial - Caretaker Arrangement: Primary care provided by mother, grandmother involved in care Review of Systems General: Positive for fatigue, lethargy, pallor. Negative for fever. HEENT: Positive for nasal contractions. Respiratory: Positive for whimpering. Gastrointestinal: Positive for vomiting, diarrhea. Negative for bloody stools.
Conjunctivitis, COVID
Egg
EXAMS: 5/16/2025 001828653 RAD ABDOMEN 1 VW - RAD ABDOMEN 1 VW HISTORY: ACUTE CONSTIPATION TECHNIQUE: One view COMPARISON: Abdomen radiographs dated 5/11/2025 FINDINGS: Nonspecific bowel gas pattern with mildly dilated loops of bowel. Bowel distention is mildly improved compared to prior. No evidence for free intraperitoneal air. No suspicious calcifications or acute osseous changes. IMPRESSION: Nonspecific bowel gas pattern with mildly dilated loops of bowel. Bowel distention is mildly improved compared to prior.