Received Jan 9, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (AFLURIA) | SEQIRUS, INC. | UNK | 90655 | IM / LA |
Seen in heme/onc clinic 12/18/2025 for follow up hx osteosarcoma (no evidence of recurrence after treatment), received influenza vaccine at heme/onc clinic late morning, felt well that day at time of appointment in AM. That evening, developed acute onset fever and chills with significant body aches. Fever continued x 2 days, ongoing aches and feeling very unwell subsequently and presented to ER 12/22/2025; never had congestion/cough. Low sodium 128, elevated AST/ALT then of unclear cause, ultrasound showed gallbladder wall thickening without evidence of gallstones. Received IV fluids and discharged home with diagnosis suspected viral illness with dehydration and secondary hepatitis. Increased AST/ALT, alk phos, bilirubin with persistent mild low sodium 12/30/2025. Negative for acute HepA/B/C, EBV, tick-borne illness. Increased nausea and sore throat 12/31/2025 and +strep PCR in office, started antibiotics (azithromycin). Prescribed ondansetron given worsening nausea which helped relieve symptoms Seen in ER 1/3/2025 and labs showed stable alk phos 527, stable AST 1529, increased ALT 2781, nml coags, nml tylenol <10, Hgb 11.2/Hct 32.5; repeat ultrasound improved (normal right upper quadrant ultrasound with nml gallbladder wall, RUQ nontender). Discussed potential for hospital admission but ultimately was discharged home after discussion. Lab recheck 1/7/2026 now with down trending liver enzymes and feeling better as of 1/8/2026 (itching , sceral icterus, dark urine improved), serum/urine studies consistent with SIADH (but serum sodium improving); plan for repeat labs one week. Unclear given onset sx whether triggered by vaccine vs. separate viral illness (never tested in ER for flu/covid/rsv/viral panel) vs. strep infection (given later strep +).
None
Generalized anxiety disorder, constipation, history of sacral osteosarcoma diagnosed (8/2021 s/p chemotherapy, surgical resection, and radiation through 9/2022, no evidence of recurrence as of 12/2025; premature ovarian insufficiency (related to cancer treatment), monoallelic mutation of MUTYH gene
Buproprion Hcl ER (SR) 200mg PO twice daily, sertraline 50mg PO daily, Vitamin D 1000IU PO daily, Estradiol 0.1mg/24hr patch change every 3 days, progesterone 200mg PO x 14 days every 2mo, miralax 1/4 to 1 capful once daily
compazine, prochlorperazine, seasonal allergies
12/22/2025: Na+ 128, BUN 7/Cr 0.7, alk phos 416, ALT 613, AST 211, Tbili 0.9; Hgb 11.6/Hct 34.1; nml TSH Hepatitis panel w/ evidence of immunity to HepA and HepB without active disease, negative HepC Repeat labs: 12/30/25 - Na+ 134, BUN 10/Cr 0.9, alk phos 602, ALT 2507, AST 2493, Tbili 1.9 Added on creatinine kinase to rule out rhabomyolysis, CK nml at 27; urine myoglobin mildly elevated (33) Monospot and EBV titers added and also negative; tick panel negative Repeat labs: 12/31/25 - Lab - Na+ 132, BUN 0.8/Cr 0.7, alk phos 597, AST 1555, ALT 2217, Tbili 2.1; Hgb 11.6/Hct 35.2 Labs in ER 1/3/2026: alk ohos 527, stable AST 1529, increased ALT 2781, nml coags, nml tylenol <10, Hgb 11.2/Hct 32.5 01/03/26 - Ultrasound Result- normal right upper quadrant ultrasound with nml gallbladder wall, RUQ nontender Labs 1/7/2026: LFTs improving: AST is 542 and ALT is 1468, alk phos 385, bili 0.9, serum Na+ 135/osm 286, urine Na+ 52/osm 361; Normal ESR; CMV and autoimmune panel pending, retic count 1.5 with Hgb 11.6/Hct 34.5; plan for repeat labs 1 week