Received Feb 16, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| PNC21 | PNEUMO (CAPVAXIVE) | MERCK & CO. INC. | 1 | Z013052 | IM / UN |
She had received a pneumovax vaccine 1.5 weeks prior to admission and had no other preceding illness. Her presentation included ascending paralysis with proprioceptive loss starting in the legs and eventually length dependent fashion including hands directed centrally. Her symptoms started 2/7/26 and more recently had dysphagia without respiratory involvement. MRI of the brain and cervical spine showed bilateral neuroforaminal stenosis in the cervical spine but no acute lesions. On examination, she was areflexic with proprioceptive deficits in the legs up to the knees and in the fingertips. Lumbar puncture under fluoroscopy demonstrated albumino-cytologic dissociation consistent with Guillain-Barré Syndrome. Patient ultimately intubated and placed on mechanical ventilation due to respiratory failure 2/12. Plasma exchange initiated 2/10, given q48h with intended duration of 7 doses.
None
Fibromyalgia, chronic upper back pain, anxiety, depression, hypertension, lupus
Albuterol inhaler 2 puffs q6h prn SOB, Symbicort 160/4.5 2 puffs BID, Buproprion XL 300 mg PO qAM, cyclobenzeprine 10 mg PO tid prn spasm, folic acid 1 mg PO daily, gabapentin 600 mg PO TID, hydroxychloroquin 200 mg PO BID, lisinopril-HCTZ
cephalexin, sulfa, penicillins
MRI brain w/o contrast 2/10 - No abnormal signal alteration of the brain parenchyma. The ventricles and sulci are normal. No acute intracranial hemorrhage or abnormal extra-axial fluid collection. No restricted diffusion or acute infarct. No abnormal enhancement. Flow-voids are normal for major intracranial arteries and dural venous sinuses. Lens replacements are present. Orbital structures are unremarkable. The mastoid air cells are clear. CSF 2/10 - clear, colorless, 2 WBC, 1 RBC, 16 neutrophils, 23 lymphocytes, 2 basophils,59 monocytes, glucose 61, protein 122. CSF cx 2/10 NGTD.