CHIEF COMPLAINT: Reinduction MEC therapy

PRESENT ILLNESS: [**Known firstname **] [**Known lastname **] is a 38-year-old Chinese-speaking female with a history
of secondary AML from her treatment for breast cancer, is
currently day 165 status post allogeneic stem cell transplant
from an unrelated donor for TBI and Cytoxan for conditioning
regimen. The donor was noted to be an antigen B mismatch, noted
to have an antigen mismatch as well as to B core positive
hepatitis B. The donor had a negative viral load. Ms. [**Known lastname **] had
been on lamivudine prophylactically. The patient had been doing
very well as an outpatient until a couple of weeks ago when she
is noted to have some blasts in the peripheral smear. Bone
marrow biopsy and aspirate revealed full both morphological and
cytogenetic evidence of disease relapse, noted at that to be 98%
donor. She was rapidly tapered off immunosuppression in order to
stimulate the donor T cells to hopefully initiated graft versus
leukemia effect. She has had no clear evidence of GVH at this
time, did develop a maculopapular rash and spotty areas around
the neck, back, torso, arms, and legs, which was very pruritic,
was evaluated by dermatology who thought that perhaps it was an
eczematous process possibly brought on by MRI contrast and was
not thought to be GVH, treated empirically initially with Lidex
ointment and then switched to triamcinolone cream with almost
complete resolution of the rash.
.
She has required periodic blood and platelet support since her
relapse. She recently has not had any evidence of circulating
blasts in her peripheral smear. She did have a bone marrow
biopsy and aspirate last week; the results are currently
pending. The patient reports that the rash had almost completely
resolved until a day or so ago when she had recrudescence of
some of her symptoms, started to use the triamcinolone cream
again and her symptoms have improved. She does continue to have
some mild pruritus in her chest and back. She notes that over
the last couple of days her eyes felt tired and dry. She notes
some pressure behind her right eye and has not really had any
headaches over the last couple of days but did have some
headaches a few weeks ago. We did an MRI which was essentially
negative. She continues to report significant fatigue and lack
of appetite. She denies any further back pain. Otherwise, denies
any nausea, vomiting, diarrhea, or constipation. Denies any
bleeding or bruising difficulties. Denies any fever, chills, or
night sweats. Denies any cough, shortness of breath, chest pain,
palpitations, or any other cardiac or respiratory difficulties.
Denies any lightheadedness or dizziness.
.

MEDICAL HISTORY: Past Medical History:
Secondary AML 11q23 mutation
breast CA
Graves' disease status post radioactive iodine treatment on
[**2190-9-14**] with subsequent hypothyroidism.
.
ONC Hx: She was diagnosed with Stage I (T1C, N0, M0) of right
breast diagnosed in [**2189**] and ductal in situ of the left breast
diagnosed in [**2189**].(LVI negative, ER positive, HER-2/neu
negative) She underwent wide excision with sentinel lymph node
procedure on the right along with wide excision of the left
breast. She also received four cycles of Adriamycin and Cytoxan
chemotherapy (completed in [**2190-11-3**]). Bilateral
mastectomies were performed in [**2191-1-26**]. Tamoxifen was
initiated in [**2191-2-1**] though was taken off at time of
diagnosis of AML.

MEDICATION ON ADMISSION: levothyroxine
lamivudine

ALLERGIES: Cefepime / Aztreonam / Levaquin

PHYSICAL EXAM: PE: Young asain woman in NAD
VS: T 98.6 BP 120/65 HR 97 RR 18 97%RA
HEENT: PERRL, OP clear
Neck: No LAD
Lungs: CTAB
Cards: tachycardic, regular rhythm, 2/6 SEM at LUSB
ABD: +BS, scaphoid, ND, tender to deep palpation mcburney's pt,
no rebound, no guarding.
Ext: +2 pulses, no edema
Neuro: Nonfocal, 5/5 strength, sensation intact
Skin: No visible rashes

FAMILY HISTORY: Sister with DM, no history of malignancy

SOCIAL HISTORY: She is originally from [**Country 651**], moved here in [**2183**]. She lives in
[**Location 86**] with her parents. She denies tobacco, alcohol or illicit
drug use. She does not have children and is single.
Encounter for antineoplastic chemotherapy,Acute myeloid leukemia, without mention of having achieved remission,Peripheral stem cells replaced by transplant,Congestive heart failure, unspecified,Acute respiratory failure,Urinary tract infection, site not specified,Personal history of malignant neoplasm of breast,Unspecified disease of pericardium,Contact dermatitis and other eczema, unspecified cause,Unspecified acquired hypothyroidism,Anemia in neoplastic disease,Dermatitis due to drugs and medicines taken internally,Other specified antibiotics causing adverse effects in therapeutic use,Diarrhea,Unspecified sinusitis (chronic),Other neutropenia,Epistaxis,Pain in or around eye,Hepatitis B carrier
Antineoplastic chemo enc,Ac myl leuk wo achv rmsn,Trspl sts-perip stm cell,CHF NOS,Acute respiratry failure,Urin tract infection NOS,Hx of breast malignancy,Pericardial disease NOS,Dermatitis NOS,Hypothyroidism NOS,Anemia in neoplastic dis,Drug dermatitis NOS,Adv eff antibiotics NEC,Diarrhea,Chronic sinusitis NOS,Neutropenia NEC,Epistaxis,Pain in or around eye,Hepatitis B carrier
Admission Date:  [**2193-1-9**]              Discharge Date:   [**2193-2-18**]

Date of Birth:  [**2154-6-8**]             Sex:   F

Service: MEDICINE

Allergies:
Cefepime / Aztreonam / Levaquin

Attending:[**First Name3 (LF) 3913**]
Chief Complaint:
Reinduction MEC therapy

Major Surgical or Invasive Procedure:
none

History of Present Illness:
[**Known firstname **] [**Known lastname **] is a 38-year-old Chinese-speaking female with a history
of secondary AML from her treatment for breast cancer, is
currently day 165 status post allogeneic stem cell transplant
from an unrelated donor for TBI and Cytoxan for conditioning
regimen. The donor was noted to be an antigen B mismatch, noted
to have an antigen mismatch as well as to B core positive
hepatitis B. The donor had a negative viral load. Ms. [**Known lastname **] had
been on lamivudine prophylactically. The patient had been doing
very well as an outpatient until a couple of weeks ago when she
is noted to have some blasts in the peripheral smear. Bone
marrow biopsy and aspirate revealed full both morphological and
cytogenetic evidence of disease relapse, noted at that to be 98%
donor. She was rapidly tapered off immunosuppression in order to
stimulate the donor T cells to hopefully initiated graft versus
leukemia effect. She has had no clear evidence of GVH at this
time, did develop a maculopapular rash and spotty areas around
the neck, back, torso, arms, and legs, which was very pruritic,
was evaluated by dermatology who thought that perhaps it was an
eczematous process possibly brought on by MRI contrast and was
not thought to be GVH, treated empirically initially with Lidex
ointment and then switched to triamcinolone cream with almost
complete resolution of the rash.
.
She has required periodic blood and platelet support since her
relapse. She recently has not had any evidence of circulating
blasts in her peripheral smear. She did have a bone marrow
biopsy and aspirate last week; the results are currently
pending. The patient reports that the rash had almost completely
resolved until a day or so ago when she had recrudescence of
some of her symptoms, started to use the triamcinolone cream
again and her symptoms have improved. She does continue to have
some mild pruritus in her chest and back. She notes that over
the last couple of days her eyes felt tired and dry. She notes
some pressure behind her right eye and has not really had any
headaches over the last couple of days but did have some
headaches a few weeks ago. We did an MRI which was essentially
negative. She continues to report significant fatigue and lack
of appetite. She denies any further back pain. Otherwise, denies
any nausea, vomiting, diarrhea, or constipation. Denies any
bleeding or bruising difficulties. Denies any fever, chills, or
night sweats. Denies any cough, shortness of breath, chest pain,
palpitations, or any other cardiac or respiratory difficulties.
Denies any lightheadedness or dizziness.
.


Past Medical History:
Past Medical History:
Secondary AML 11q23 mutation
breast CA
Graves' disease status post radioactive iodine treatment on
[**2190-9-14**] with subsequent hypothyroidism.
.
ONC Hx: She was diagnosed with Stage I (T1C, N0, M0) of right
breast diagnosed in [**2189**] and ductal in situ of the left breast
diagnosed in [**2189**].(LVI negative, ER positive, HER-2/neu
negative) She underwent wide excision with sentinel lymph node
procedure on the right along with wide excision of the left
breast. She also received four cycles of Adriamycin and Cytoxan
chemotherapy (completed in [**2190-11-3**]). Bilateral
mastectomies were performed in [**2191-1-26**]. Tamoxifen was
initiated in [**2191-2-1**] though was taken off at time of
diagnosis of AML.


Social History:
She is originally from [**Country 651**], moved here in [**2183**]. She lives in
[**Location 86**] with her parents. She denies tobacco, alcohol or illicit
drug use. She does not have children and is single.


Family History:
Sister with DM, no history of malignancy


Physical Exam:
PE: Young asain woman in NAD
VS: T 98.6 BP 120/65 HR 97 RR 18 97%RA
HEENT: PERRL, OP clear
Neck: No LAD
Lungs: CTAB
Cards: tachycardic, regular rhythm, 2/6 SEM at LUSB
ABD: +BS, scaphoid, ND, tender to deep palpation mcburney's pt,
no rebound, no guarding.
Ext: +2 pulses, no edema
Neuro: Nonfocal, 5/5 strength, sensation intact
Skin: No visible rashes


Pertinent Results:
Notable Admission Labs:
WBC 0.6
ANC 110
Hgb/Hct: 11.1/30.4
plts 9
BONE MARROW BIOPSY
Note: Myeloblasts in the aspirate account for 70% of the marrow
cellularity.
.
MICROSCOPIC DESCRIPTION
Peripheral Blood Smears:
The smear is adequate for evaluation. Erythrocytes show
anisopoikilocytosis with ovalocytes, dacrocytes. The white blood
cell count appears decreased. Hypogranular neutrophils are
present. Platelet count appears normal. Large forms are seen.
Giant forms are not present. The differential shows: 13%
neutrophils, 1% bands, 2% monocytes, 90% lymphocytes, <1%
eosinophils, <1% basophils, 3% blasts.
.
Aspirate Smears
The aspirated material is adequate for evaluation. The M:E ratio
is 3.6. Erythroid precursors are markedly decreased with
megaloblastic changes. Myeloid precursors appear markedly
decreased in number and show a left-shift in maturation.
Megakaryocytes are virtually absent. The differential shows: 70%
Blasts, 4% Promyelocytes, 4% Myelocytes, 2% Metamyelocytes, 1%
Bands/Neutrophils, 2% Plasma cells, 11% Lymphocytes, 3%
Erythroid, 3% of Promonocytes/Monocytes.
.
Clot Section and Biopsy Slides
The biopsy material is adequate for evaluation. The marrow
cellularity is approximately 10-20%. Hemosiderin-laden
macrophages are noted. The predominant population consists of
interstitial blasts greater than 70% of the marrow cellularity.
Erythroid precursors are decreased and present in small
clusters. Myeloid elements are decreased. Maturing myeloid
elements are greatly decreased. Megakaryocytes are decreased
with hypolobated forms and cells with disjointed nuclei. Marrow
clot section is not submitted. Touch prep is not submitted.
.
TTE [**1-10**]:
The left atrium is normal in size. There is borderline left
ventricular
hypertrophy. The left ventricular cavity size is normal. Overall
left ventricular systolic function is normal (LVEF>55%). Right
ventricular chamber size and free wall motion are normal. The
aortic valve leaflets (3) appear structurally normal with good
leaflet excursion and no aortic regurgitation. The mitral valve
leaflets are mildly thickened. No mitral regurgitation is seen.
There is a small pericardial effusion. There are no
echocardiographic signs of tamponade.  Compared with the prior
study images reviewed) of [**2192-6-27**], there is now a small
pericardial effusion.
.
CT head [**1-24**]:
1. No intracranial hemorrhage or mass effect.
2. Persistent opacification of the right frontal sinus, anterior
right ethmoid air cell, and right maxillary sinus, the latter of
which is not completely included in the field of view.
.
CTA [**2193-2-3**]: No evidence of PE.  Large pericardial and pleural
effusion.
.
Echo [**2193-2-3**]: Moderate circumferential pericardial effusion with
evidence of mildly increased pericardial pressures and global
biventricular hypokinesis. Mild mitral regurgitation. Compared
with the prior study (images reviewed) of [**2193-1-9**], the
pericardial effusion is larger (previously very small) and
global biventricular systolic dysfunction are now evident. These
findings are suggestive of myopericarditis or other diffuse
process. Serial evaluation is suggested.
.
Echo [**2193-2-8**]: The estimated right atrial pressure is 5-10 mmHg.
LV systolic function appears depressed. Right ventricular
chamber size and free wall motion are normal. There is a
moderate sized pericardial effusion (maximal posteriorly @ 1.9
cm, minimal anteriorly at 0.8 cm). No right ventricular
diastolic collapse is seen. There is brief right atrial
collapse, consistent with low filling pressures or early
tamponade. Compared to the prior study dated [**2193-2-6**], there is no
change. These findings are suggestive of elevated
intrapericardial pressures. Given the samll IVC
size and normal respirophasic variation, a component of
intravascular volume depletion should be considered.


Brief Hospital Course:
.
# Relapsed AML: Given the extent of disease involvement the
patient was admitted to the hospital to reinduce her with MEC in
order to cytoreduce her disease prior to  receiving DLI. The
patient received 5 days of MEC therapy which she tolerated well.
She had an echo prior to starting treatment which showed normal
LV function. She has been pancytopenic and has required platelet
and blood transfusions to keep her crit > 25 and plt > [**9-21**].
After MEC a bone marrow was performed which showed a
hypocellular marrow with 85-90% blasts.  Despite the aggressive
nature of the disease, a discussion was made with the family to
continue with DLI.  DLI was not given after the patient became
hemodynamically unstable [**1-4**] pericardial tamponade and bilateral
pulmonary edema.  A decision was made to make the patient
comfort measures and not pursue further aggressive treatment
given worsening bilateral pleural effusions and persistent
tamponade in the setting of disease recurrence.  The patient
passed away peacefully with family at bedside.
.
# Febrile Neutopenia: Granulocyte count of 110 on admission.
Patient remained neutropenic thoughout this admission and
started to spike fever >102 on [**1-15**] and was started on
vancomycin and meropenem. She was already on fluconazole and
acyclovir already for prophylaxis given her neutropenia. All
culture data has been negative to date except for a urine cx
with 10,000-100,000 proteus mirabilis microorganisms. Repeat
urine cultures have been negative. On [**1-21**], pt developed a rash
and it was thought to be due to meropenem although the patient
had meropenem in the past without problem. Of note she does have
rash with aztreonam. She was taken off meropenem and started on
gentamicin. The rash was still present but not getting worse. On
[**1-26**] gentamycin was stopped and meropenem was restarted to
better cover gram negative bacteria as the patient was still
spiking fevers. On [**1-24**], the patient developed diarrhea and c
dif cultures were sent and are pending. At that time, pt was
started on flagyl. In addition, head CT showed some
opacification of ethmoid and frontal sinuses. Fungal cx sent and
is pending. CMV viral loads sent weekly have been negative. The
patient was switched briefly to Aztreonam but this too worsened
her rash and she was switched back to Gentamicin for gram
negative coverage.  Her left subclavian line was discontinued
given that it was thought to be contributing to her fevers but
the patient continued to spike despite the line being removed.
She was eventually broadened to
Posaconazole/Gentamicin/Vancomycin/Flagyl but continued to spike
fevers of unclear etiology despite multiple blood cultures.
Upon transfer to the [**Hospital Unit Name 153**] for pericardial tamponade, the patient
continued to spike fevers up to 102.  Voriconazole was added for
empiric fungal coverage.  Voriconazole was switched to
Posaconazole for mucor coverage by ID recommendation and
switching Vancomycin to Daptomycin to avoid renal toxicity.  A
repeat bone marrow biopsy was performed when the patient's
counts showed no signs of recovery.  She was found to have
recurrent disease in her bone marrow.  No source was identified
for her fevers.  A discussion with the patient and her family
was held and a decision was made to make the patient comfort
care given her aggressive disease and worsening clinical course
with worsening respiratory distress from her pulmonary edema and
pericardial tamponade.  She was given standing Tylenol to
prevent fevers and make the patient comfortable.  She passed
peacefully with family at bedside.
.
# Skin rash- Thought to be due to meropenem which was stopped
[**1-23**] and restarted on [**1-26**] for better gram neg coverage as she
was still spiking temps. She was briefly switched to Aztreonam
which also seemed to worsen the rash.  Dermatology saw the
patient and a biopsy showed spongiotic changes which were
thought to be more likely consistent with drug rash although
GVHD could not be ruled out.  She was given Triamcinolone cream
for symptomatic relief and the rash slowly improved when she was
switched off Meropenem/Aztreonam to Gentamicin.
.
# Mucositis- Patient developed mucositis after reinduction with
MEC. She was given mouth care with nystatin, caphasol,
clotrimazole troches prior to mucositis. She was also being
covered for viral and fungal causes with fluconazole and
acyclovir. The fluconazole was switched to caspofungin when she
was still spiking fevers. Her pain was well-controlled with a
fentanyl pca and improved during her stay. Patient was start on
TPN since it was difficult for her to eat [**1-4**] mouth pain.
.
# Hypothyroidism- Continued on home dose of levothyroxine.
.
# History of Hep B positive donor- Continued prophylaxis with
lamivudine. Her Hepatitis B viral load was negative. This was
checked as her LFTS were elevated with MEC. They trended down to
normal after MEC was completed.
.
# Epistaxis- This occured in setting of plt count < 20 K. She
was given plts to keep goal > 35,000 and afrin nasal spray. ENT
consulted and nose was never packed. This did not happen again
during this admission.
.
# Pericardial effusion and Tamponade Physiology: On the day of
transfer to the [**Hospital Unit Name 153**], the patient was found to have increased
SOB and increasing O2 requirement.  A chest CT showed evidence
of a pericardial effusion and TTE showing RA/RV collapse in
diastole. In the [**Hospital Unit Name 153**], the patient was monitored with serial
echos which showed persistent evidence of tamponade physiology.
The etiology of her pericardial effusion was unclear.  The fluid
collection was not thought to be drainable given its posterior
location.  She was diuresed as needed for volume overload
demonstrated on CXR.  Ambisome was added for empiric fungal
coverage.  Her echo continued to show evidence of worsening
tamponade physiology.  Upon transfer back to the floor, the
patient's respiratory status worsened with tachycardia to the
150s, severe pulmonary edema and increased O2 requirement
despite diuresis.  A discussion with the patient and her family
was held and the patient did not want to return to the ICU.
Instead, comfort care measures were pursued.  The patient was
eventually placed on a Fentanyl gtt for respiratory distress and
made comfortable.  She passed away peacefully with family at
bedside.
.
# Dispo: Please see above for details of hospital course.  The
patient was found to have aggressive disease with recurrence of
AML in the marrow after the patient underwent MEC.
Concurrently, a large pericardial effusion was identified with
tamponade physiology and worsening pulmonary edema.  A
discussion with the patient and her family was held and a
decision was made to make the patient comfort measures.  She was
made comfortable on a Fentanyl gtt and passed peacefully with
her family at bedside.
.


Medications on Admission:
levothyroxine
lamivudine

Discharge Medications:
N/A

Discharge Disposition:
Home

Discharge Diagnosis:
Primary
1. Secondary AML
2. H/O breast cancer
3. Pancytopenia
4. Pericardial effusion and Tamponade
5. Pleural effusions
.
Secondary
1. Hypothyroidism


Discharge Condition:
Patient passed away peacefully with her family at bedside.


Completed by:[**2193-2-18**]
{'Encounter for antineoplastic chemotherapy,Acute myeloid leukemia, without mention of having achieved remission,Peripheral stem cells replaced by transplant,Congestive heart failure, unspecified,Acute respiratory failure,Urinary tract infection, site not specified,Personal history of malignant neoplasm of breast,Unspecified disease of pericardium,Contact dermatitis and other eczema, unspecified cause,Unspecified acquired hypothyroidism,Anemia in neoplastic disease,Dermatitis due to drugs and medicines taken internally,Other specified antibiotics causing adverse effects in therapeutic use,Diarrhea,Unspecified sinusitis (chronic),Other neutropenia,Epistaxis,Pain in or around eye,Hepatitis B carrier'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: Reinduction MEC therapy

PRESENT ILLNESS: [**Known firstname **] [**Known lastname **] is a 38-year-old Chinese-speaking female with a history
of secondary AML from her treatment for breast cancer, is
currently day 165 status post allogeneic stem cell transplant
from an unrelated donor for TBI and Cytoxan for conditioning
regimen. The donor was noted to be an antigen B mismatch, noted
to have an antigen mismatch as well as to B core positive
hepatitis B. The donor had a negative viral load. Ms. [**Known lastname **] had
been on lamivudine prophylactically. The patient had been doing
very well as an outpatient until a couple of weeks ago when she
is noted to have some blasts in the peripheral smear. Bone
marrow biopsy and aspirate revealed full both morphological and
cytogenetic evidence of disease relapse, noted at that to be 98%
donor. She was rapidly tapered off immunosuppression in order to
stimulate the donor T cells to hopefully initiated graft versus
leukemia effect. She has had no clear evidence of GVH at this
time, did develop a maculopapular rash and spotty areas around
the neck, back, torso, arms, and legs, which was very pruritic,
was evaluated by dermatology who thought that perhaps it was an
eczematous process possibly brought on by MRI contrast and was
not thought to be GVH, treated empirically initially with Lidex
ointment and then switched to triamcinolone cream with almost
complete resolution of the rash.
.
She has required periodic blood and platelet support since her
relapse. She recently has not had any evidence of circulating
blasts in her peripheral smear. She did have a bone marrow
biopsy and aspirate last week; the results are currently
pending. The patient reports that the rash had almost completely
resolved until a day or so ago when she had recrudescence of
some of her symptoms, started to use the triamcinolone cream
again and her symptoms have improved. She does continue to have
some mild pruritus in her chest and back. She notes that over
the last couple of days her eyes felt tired and dry. She notes
some pressure behind her right eye and has not really had any
headaches over the last couple of days but did have some
headaches a few weeks ago. We did an MRI which was essentially
negative. She continues to report significant fatigue and lack
of appetite. She denies any further back pain. Otherwise, denies
any nausea, vomiting, diarrhea, or constipation. Denies any
bleeding or bruising difficulties. Denies any fever, chills, or
night sweats. Denies any cough, shortness of breath, chest pain,
palpitations, or any other cardiac or respiratory difficulties.
Denies any lightheadedness or dizziness.
.

MEDICAL HISTORY: Past Medical History:
Secondary AML 11q23 mutation
breast CA
Graves' disease status post radioactive iodine treatment on
[**2190-9-14**] with subsequent hypothyroidism.
.
ONC Hx: She was diagnosed with Stage I (T1C, N0, M0) of right
breast diagnosed in [**2189**] and ductal in situ of the left breast
diagnosed in [**2189**].(LVI negative, ER positive, HER-2/neu
negative) She underwent wide excision with sentinel lymph node
procedure on the right along with wide excision of the left
breast. She also received four cycles of Adriamycin and Cytoxan
chemotherapy (completed in [**2190-11-3**]). Bilateral
mastectomies were performed in [**2191-1-26**]. Tamoxifen was
initiated in [**2191-2-1**] though was taken off at time of
diagnosis of AML.

MEDICATION ON ADMISSION: levothyroxine
lamivudine

ALLERGIES: Cefepime / Aztreonam / Levaquin

PHYSICAL EXAM: PE: Young asain woman in NAD
VS: T 98.6 BP 120/65 HR 97 RR 18 97%RA
HEENT: PERRL, OP clear
Neck: No LAD
Lungs: CTAB
Cards: tachycardic, regular rhythm, 2/6 SEM at LUSB
ABD: +BS, scaphoid, ND, tender to deep palpation mcburney's pt,
no rebound, no guarding.
Ext: +2 pulses, no edema
Neuro: Nonfocal, 5/5 strength, sensation intact
Skin: No visible rashes

FAMILY HISTORY: Sister with DM, no history of malignancy

SOCIAL HISTORY: She is originally from [**Country 651**], moved here in [**2183**]. She lives in
[**Location 86**] with her parents. She denies tobacco, alcohol or illicit
drug use. She does not have children and is single. 

### Response:
{'Encounter for antineoplastic chemotherapy,Acute myeloid leukemia, without mention of having achieved remission,Peripheral stem cells replaced by transplant,Congestive heart failure, unspecified,Acute respiratory failure,Urinary tract infection, site not specified,Personal history of malignant neoplasm of breast,Unspecified disease of pericardium,Contact dermatitis and other eczema, unspecified cause,Unspecified acquired hypothyroidism,Anemia in neoplastic disease,Dermatitis due to drugs and medicines taken internally,Other specified antibiotics causing adverse effects in therapeutic use,Diarrhea,Unspecified sinusitis (chronic),Other neutropenia,Epistaxis,Pain in or around eye,Hepatitis B carrier'}
