Received Sep 23, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| DTAPIPV | DTAP + IPV (QUADRACEL) | SANOFI PASTEUR | 5 | U8623AA | IM / LL |
| FLU3 | INFLUENZA (SEASONAL) (FLUZONE) | SANOFI PASTEUR | 1 | UT8779KA | IM / RL |
| MMRV | MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) | MERCK & CO. INC. | 2 | Z010731 | SC / LL |
Patient returned to clinic approximately 10 minutes after being immunized with new onset pruritic rash over neck and torso as well as slight lower right eye swelling. Denied any cough lip or tongue swelling respiratory distress vomiting or diarrhea. Exam notable for pinpoint erythematous papules over torso and bilateral proximal upper extremities as well as very slight right inferior periocular swelling. Reassuring repeat vitals with administration of Benadryl 1 mg/kg. After 20-minute reevaluation, right periocular swelling had decreased significantly with rash still stable/persistent notable on the torso and proximal bilateral upper extremities. As patient was doing well, mother comfortable with continued following at this time and would recommend repeat Benadryl in 6 hours with utilization as needed thereafter. Discussed ED return precautions and red flag symptomatology for which to continue monitoring to include recurrent facial swelling, lip/tongue swelling, respiratory distress, cough, vomiting, diarrhea. Patient has tolerated these immunizations in the past however as this does seem suspicious for class I hypersensitivity reaction, will place consultation to allergist for recommendations in regards to future immunizations. Mother verbalized understanding/agreement of plan.
8/26/2025: ED visit for possibility of early bacterial conjunctivitis, received topical antibiotic eye drops
None listed
NKDA, NKFA
Vitals documented on 9/19 @ 1323: T: 37.1 C, HR = 88, BP: 97/60 rr= 24 O2 SAT: 98% Vitals documented on 9/19 @ 1451: T: 37.3 C, HR = 89, BP: 100/64 RR = 28 O2 SAT: 98%