Symptomtext
Reported Symptoms: 10002218:ANAPHYLAXIS; 10002391:ANGINAL PAIN; 10011232:COUGHING; 10019211:HEADACHE; 10040604:SHORTNESS OF BREATH; 1004700:VOMITING; Narrative: 44 YO M w/ PMHx of nephrolithiasis, alcohol use disorder, chronic neuropathic pain, PTSD, and depression presented to primary care clinic for a routine follow-up and received influenza (Fluzone) and 20-valent pneumococcal conjugate (Prevnar 20) vaccines at approximately 9:15 AM on 9/19/23. Patient called the nurse triage line at approximately 9:00 PM to report a burning sensation in his chest, headache, and cough that had started gradually after receiving the immunizations and was directed to go to the emergency room. He presented to the emergency room reporting the previous symptoms as well as shortness of breath. Symptoms progressed to also include hoarse voice, nausea, vomiting, and feeling of "tickling in throat" similar to anaphylactic reactions to shellfish in the past. Of note, patient has received the influenza vaccine previously without adverse reactions noted. He received 4 puffs of inhaled albuterol, epinephrine 0.3mg IM, methylprednisolone 125mg IV, diphenhydramine 50mg IV, ondansetron 4mg IV, famotidine 20mg IV, and 1 L of Lactated Ringer's with improvement in symptoms. He received an additional epinephrine 0.3mg IM and acetaminophen 650mg by mouth for remaining tightness in throat/chest and headache. Following further improvement and stability, patient was discharged from the emergency room with Epi-Pens, famotidine 20mg BID as needed for allergic reaction, and methylprednisolone dose pack. On 9/21/23, he reported to primary care nurse that symptoms were continuing to improve though still noted some remaining shortness of breath on exertion. Other Relevant HX: Patient has previously received flu shot (2022, 2021, 2019, 2015, 2010) without adverse reactions. Other: shortness of breath