Symptomtext
Patient reported swelling of face and throat - top lip swollen very significantly. (Dx: Angioedema) Went to ED same day as vaccinations administered. (influenza and COVID booster dose) Hospital Emergency; 11/20/2021 CHIEF COMPLAINT: POSSIBLE ALLERGIC REACTION (Had Flu shot and Pfizer booster shot today, now having swelling to upper lip worsening. Took tylenol at 2215. Was having neck pain and chills - resolved with tylenol. ) DIAGNOSIS at time of disposition: 1. Angioedema, initial encounter Follow-up Information Call, MD. Specialty: Family Medicine ED Course as of 11/21/21 0151 Sun Nov 21, 2021 0137 Patient is a very pleasant 19-year-old female that presents emergency department with swelling to her upper lip that she noticed about 40 minutes prior to arrival. She states she received her Pfizer booster and her influenza vaccine around 11:00 a.m., just after 10:00 p.m. she began developed some subjective fevers chills and body ache and neck ache and noticed swelling to her upper lip. The Tylenol resolved all the symptoms except her lip and thus she presented to the emergency department for evaluation. She denies any tongue swelling, no feeling her throat closing, no difficulty swallowing or breathing. On exam she had mild upper lip swelling but thankfully the rest of her exam was reassuring. She states her lips felt pruritic but she had no evidence of urticaria on exam. An IV was started, the patient was provided Solu-Medrol, Pepcid, Benadryl and monitored closely for the last nearly 3 hours duration. The patient was checked several times, the most recent of which showed improvement of her lip swelling (although not full resolution). Thankfully she is well-appearing and not showing evidence of anaphylaxis. She has had no new symptoms or worsening symptoms. Plan is for the patient to be able to go at the 3 hour mark. I have written her for Prednisone for home for the next 5 days, and discussed use of OTC Benadryl and Pepcid for the next 5 days. I have advised her that she should likely not receive any additional Pfizer COVID vaccine or the standard flu vaccine in the future. We also discussed emergency department return precautions including a worsening of her lip swelling, swelling to her tongue, the feeling of swelling to her throat, difficulty breathing, or difficulty swallowing. The patient verbalized understanding instructions all questions were answered. She and her mother were agreeable with the plan of care discharged home. [EC] 0150 Patient has been in the emergency department for 3 hours, continues to be doing well and to be discharged as previously discussed. [EC]