Received Oct 12, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLUN3 | INFLUENZA (SEASONAL) (FLUMIST) | MEDIMMUNE VACCINES, INC. | UNK | — | IN / NS |
Presented with status epilepticus one day after receiving FluMist. As noted previously, had viral symptoms about 10/4/25, including fever, headache, myalgias that had resolved. By 10/9 he had improved and received intranasal flu vaccine 10/10. That evening, he had one episode of emesis, and later that evening an episode of lip smacking, drooling, and purple lips, lasting about one minute. Unresponsive during the episode, but responsive afterward. He had 2 other similar episodes during the course of the night. (One of them had shaking of his arms.). No fevers during the time of the seizures. Family called EMS, and he had another seizure en route, for which they gave 4 mg IV versed. He has had associated headache for the last week, and the evening of 10/10 had some uncoordinated movements in which he dropped his books. No focal weakness, no slurred speech, no loss of consciousness, no history of brain injury, no previous history of seizures. In the ED he was febrile to 100.4, otherwise normal vitals. He had another seizure in the ED with R eye deviation and hypoxia. Neurology was consulted, and he was given 40 mg/kg of IV keppra and he was admitted to the acute care floor. On the floor, EEG was placed, which showed slowing but was generally unrevealing. He had 3 further seizures with tongue movements and head shaking over the course of 4 hours, and receive 3 doses of versed, as well as 10 mg/kg additional keppra in addition to his maintenance. Due to ongoing seizures with frequent AED dosing, he was transferred to the PICU. He was initially post ictal and sleepy, but maintaining his airway. After having further seizures, he received fosphenytoin, became hypopneic and hypercarbic, and was intubated. Head CT negative. LP was done, and CSF studies are reassuring against meningitis. MRI/MRV pending to rule out ADEM and thrombosis. Initial viral panel positive for flu A/B (thought to be false positive, given recent live flu vaccine). Follow up panel positive for COVID and rhino/enterovirus (and notably negative for flu).
Viral symptoms beginning about 10/4/25, including fever, headache, myalgias (fevers lasted a few days and then resolved). By 10/9, he had improved and received intranasal flu vaccine 10/10.
autism
ZINC CITRATE-QUERCETIN ORAL
Pistachios, tree nuts
CBC, CMP, respiratory viral panel, CSF studies, CT head, MRI/MRV brain, blood gas, chest x-ray