Received Sep 10, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| DTAPHEPBIP | DTAP + HEPB + IPV (PEDIARIX) | GLAXOSMITHKLINE BIOLOGICALS | UNK | — | — |
| IPV | POLIO VIRUS, INACT. (IPOL) | SANOFI PASTEUR | UNK | — | — |
| PNC20 | PNEUMO (PREVNAR20) | PFIZER\WYETH | UNK | — | — |
? 2 Sep 2025 (evening): Petechiae noted around vaccination sites. ? 8 Sep 2025: Severe thrombocytopenia (life-threatening) diagnosed; patient developed intracranial hemorrhage (brain bleed). ? Intervening symptoms: Epistaxis (bloody nose), gross hematuria, new blisters on arms and face.
? Loop recorder and electrophysiology follow-up ? Recent start of Gemtesa (vibegron) for overactive bladder (2 weeks ago)
? High-grade B-cell lymphoma (Burkitt/Burkitt-like), diagnosed 2021, relapse 2024, treated with DA?R-EPOCH (with prior chemotherapy-associated thrombocytopenia in 2021), polatuzumab, rituximab, and CAR-T cell therapy (Nov 2024). Most recent PET scan (Deauville 1-2) shows no evidence of active disease. ? Prostate cancer (active surveillance) ? Chronic kidney disease (minimal change disease, managed with tacrolimus, previously on prednisone) ? Hypercoagulability (antithrombin III deficiency, prior PE, central retinal vein occlusion) ? Not on chronic anticoagulation due to GI bleeding; restarted Xarelto and aspirin after retinal vein occlusion in 2023 ? Residual vision loss (left eye)
? Tacrolimus (for minimal change disease) ? Gemtesa (vibegron) started 2 weeks prior ? Aspirin and Xarelto (restarted in 2023, not currently on chronic anticoagulation)
No medications. Seasonal allergy
CBC prior to vaccination same day ? WBC 6.33 k/uL Hgb 11.0 g/dL, Platelet count 182k/UL Platelet count on presentation 9/8 less than 2 k/UL