Received Jul 15, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| DTAPIPVHIB | DTAP + IPV + HIB (PENTACEL) | SANOFI PASTEUR | UNK | — | — |
| HIBV | HIB (ACTHIB) | SANOFI PASTEUR | UNK | — | — |
| IPV | POLIO VIRUS, INACT. (IPOL) | SANOFI PASTEUR | UNK | — | — |
| PNC15 | PNEUMO (VAXNEUVANCE) | MERCK & CO. INC. | UNK | — | — |
| RV5 | ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | UNK | — | PO / MO |
Adverse Event: Following administration of routine 2-month vaccines on April 15, 2025 including the oral rotavirus vaccine my daughter developed persistent diarrhea, poor weight gain, hypoalbuminemia, and elevated inflammatory markers within days. Stools became green, watery, and mucousy with visible intestinal sloughing. She was ultimately diagnosed with severe intestinal inflammation with crypt dropout and eosinophilic infiltration on biopsy, consistent with an early inflammatory bowel disease process or severe immune dysregulation. She required bowel rest, TPN (total parenteral nutrition), and hospitalization for over 6 weeks. Treatment: She was made NPO and placed on TPN. She was started on steroids (methylprednisolone then transitioned to prednisolone) and famotidine. Elemental formula (Neocate) was introduced slowly via NG and PO feeds as symptoms improved. Outcome: We were discharged on in early June and she has continued to do very well. She is now gaining weight, having normal stools, and is tolerating feeds by mouth. She is currently titrating off of both steroids and famotidine. No further signs of active inflammation or diarrhea since discharge.
RSV at 1 week old
None
None
Inflammatory markers: CRP peaked at 29.9 mg/dL, trending down to 1.1 mg/dL at discharge (May 26, 2025). Procalcitonin 23.6 ng/mL with no bacterial source identified. CXCL9 elevated at 1,763 pg/mL. CBC: WBC up to 19.7 x10?/L, Platelets 754 x10?/L. Hemoglobin 9.7 g/dL, Hematocrit 28%. Chemistry and albumin: Albumin dropped to 1.3 g/dL, improved to 2.4 g/dL by discharge (goal =3.5). Sodium 131 132 mEq/L, BUN 22 mg/dL, CO2 10 mEq/L indicating mild acidosis. Stool studies: Stool sodium 118 120 mEq/L, potassium 7 8 mEq/L, osmolality 306 mOsm/kg (osmotic gap ~34). Stool pH 5, reducing substances negative. Fecal calprotectin elevated at 402 µg/g. Alpha-1-antitrypsin mildly elevated at 0.47 mg/g. Endoscopy and biopsy (May 23, 2025): Showed diffuse active inflammation, crypt dropout, regenerative crypts, lamina propria eosinophils, and gastric antralization. Pathology consistent with early inflammatory bowel disease vs. severe milk protein allergy. Imaging: Abdominal ultrasound showed no obstruction; noted gallbladder sludge which later resolved. Cultures: Blood, urine, and CSF cultures all negative (April 24, 2025). Genetic and Immunology Testing (Invitae panel): No congenital diarrhea variant No monogenic cause of neonatal IBD identified.