Syncope in a 16-year-old girl

摘要

A previously healthy 16-year-old girl is transferred from a referring facility for syncope and altered mental status. The previous day, she received the meningococcal vaccine. After a stressful conversation with her father, she began to complain of chest pain, diaphoresis, and nausea. She vomited, became clammy, and fell to the ground unresponsive. She was brought to the referring facility, where she was given epinephrine, diphenhydramine, methylprednisolone, famotidine, and 4 L of isotonic fluids for a possible anaphylactic reaction to the vaccine. She remained groggy, tachycardic, and anuric.