CHIEF COMPLAINT: Pain with swallowing, hoarse voice, admitted after ENT saw
epiglottitis on laryngoscopy

PRESENT ILLNESS: 66 yo F w/ recent diverticulitis p/w dysphagia x 5d. Pt had
otherwise been completely healthy until mid-[**Month (only) **], when developed
abdominal pain and diarrhea. She was hospitlaized in [**Location (un) **],
[**Location (un) **], where [**Doctor Last Name **] had been living for several months. There,
she had a negative C. diff and CT abd/pelvis showed
diverticulitis. She was treated with amox/clavulnate since then
to finish a 4-week course. Since then she has had
near-resolution of the abdominal pain and diarrhea. 5 days ago
she developed acute sore throat. It progressively got worse
until she was seen in the ED [**2151-6-13**], where monospot was sent and
was negative, and given the number for outpt ENT, where she was
seen [**2151-6-14**]. Laryngoscopy showed epiglottitis. She was sent to
the [**Hospital Ward Name **] for direct admission, and then ENT suggested she
be admitted to the ICU for continuous O2 sat monitoring.

MEDICAL HISTORY: Diverticulitis recently
Chronic back pain secondary to spondylosis
Arthritis
s/p appendectomy, cholecystectomy, tonsillectomy, tubal ligation
GERD

MEDICATION ON ADMISSION: Amox/clav 875 x [**5-20**]
Percocet prn
Lidocaine viscous
Ibuprofen
Estring

ALLERGIES: Nsaids

PHYSICAL EXAM: T 98.8, BP 128/84, P 97, RR 20, O2 96% RA
GEN: Well nourished, pleasant
HEENT: PERRL, EOMI, MMM, erythematous posterior OP
CV: RRR normal S1/S2
PULM: CTA, no stridor, no wheeze
ABD: NABS s/nd/nt
EXTR: No c/c/e, 2+ DP
NEURO: AAOx3, nonfocal

FAMILY HISTORY: No DM, CAD, HTN. MGM and PGF with colon CA. Fathre died
secondary to aortic aneurysm.

SOCIAL HISTORY: No sick contacts. History of tobacco, quit at age 50. occasional
EtOH, no IVDU. Lives with husband, has 2 children. Teaches one
class at [**University/College 5130**]. Was at [**Location (un) **] working on a book.
Independent ADL's.
Acute epiglottitis without mention of obstruction,Candidiasis of mouth,Diverticulitis of colon (without mention of hemorrhage),Esophageal reflux,Vaginitis and vulvovaginitis, unspecified,Spondylosis of unspecified site, without mention of myelopathy
Ac epiglottitis no obstr,Thrush,Dvrtcli colon w/o hmrhg,Esophageal reflux,Vaginitis NOS,Spondylos NOS w/o myelop
Admission Date:  [**2151-6-14**]              Discharge Date:   [**2151-6-21**]

Date of Birth:  [**2084-11-12**]             Sex:   F

Service: MEDICINE

Allergies:
Nsaids

Attending:[**First Name3 (LF) 30**]
Chief Complaint:
Pain with swallowing, hoarse voice, admitted after ENT saw
epiglottitis on laryngoscopy

Major Surgical or Invasive Procedure:
None


History of Present Illness:
66 yo F w/ recent diverticulitis p/w dysphagia x 5d. Pt had
otherwise been completely healthy until mid-[**Month (only) **], when developed
abdominal pain and diarrhea. She was hospitlaized in [**Location (un) **],
[**Location (un) **], where [**Doctor Last Name **] had been living for several months. There,
she had a negative C. diff and CT abd/pelvis showed
diverticulitis. She was treated with amox/clavulnate since then
to finish a 4-week course. Since then she has had
near-resolution of the abdominal pain and diarrhea. 5 days ago
she developed acute sore throat. It progressively got worse
until she was seen in the ED [**2151-6-13**], where monospot was sent and
was negative, and given the number for outpt ENT, where she was
seen [**2151-6-14**]. Laryngoscopy showed epiglottitis. She was sent to
the [**Hospital Ward Name **] for direct admission, and then ENT suggested she
be admitted to the ICU for continuous O2 sat monitoring.

Past Medical History:
Diverticulitis recently
Chronic back pain secondary to spondylosis
Arthritis
s/p appendectomy, cholecystectomy, tonsillectomy, tubal ligation
GERD

Social History:
No sick contacts. History of tobacco, quit at age 50. occasional
EtOH, no IVDU. Lives with husband, has 2 children. Teaches one
class at [**University/College 5130**]. Was at [**Location (un) **] working on a book.
Independent ADL's.

Family History:
No DM, CAD, HTN. MGM and PGF with colon CA. Fathre died
secondary to aortic aneurysm.

Physical Exam:
T 98.8, BP 128/84, P 97, RR 20, O2 96% RA
GEN: Well nourished, pleasant
HEENT: PERRL, EOMI, MMM, erythematous posterior OP
CV: RRR normal S1/S2
PULM: CTA, no stridor, no wheeze
ABD: NABS s/nd/nt
EXTR: No c/c/e, 2+ DP
NEURO: AAOx3, nonfocal

Pertinent Results:
[**2151-6-14**] 08:34PM   PLT COUNT-325
[**2151-6-14**] 08:34PM   NEUTS-78.7* LYMPHS-20.5 MONOS-0.7* EOS-0.1
BASOS-0.1
[**2151-6-14**] 08:34PM   WBC-17.2* RBC-4.04* HGB-11.8* HCT-35.1*
MCV-87 MCH-29.3 MCHC-33.7 RDW-14.1
[**2151-6-14**] 08:34PM   CALCIUM-9.8 PHOSPHATE-3.8 MAGNESIUM-2.0
[**2151-6-14**] 08:34PM   GLUCOSE-123* UREA N-14 CREAT-0.5 SODIUM-141
POTASSIUM-4.1 CHLORIDE-104 TOTAL CO2-24 ANION GAP-17

Brief Hospital Course:
Ms. [**Known lastname 44038**] is a 66 year old female with recent diverticulitis,
presenting with five days of dysphagia. She was admitted after
an urgent visit to ENT, in which laryngoscopy showed
epiglottitis. She was initally treated with IV Unasyn; however,
given concern that she may have developed epiglotitis while on
Augmentin (was being treated with augmentin for diverticulitis),
her antibiotics were switched to ceftriaxone and clindamycin. On
this regimen she had improvement of her symptoms and she was
transferred to the floor on [**2151-6-17**].
.
On the floor, she developed LLQ pain similar to her
diverticulitis pain. CT scan was done on [**2151-6-18**], showing
thickening of the sigmoid colon with fat stranding. Surgery
consulted and felt imaging and the physical exam were both
consistent with diverticulis. Clindamycin and ceftriaxone were
stopped (did recieve doses in afternoon on [**2151-6-18**]) and
Levo/flagyl were started on [**2151-6-18**]. Ampicillin was added later
that day as well (dose X1). She was also given a single dose of
fluconazole for vaginitis and started on nystatin S&S for oral
thrush.
.
On [**6-19**] she complained of increased swelling in her throat.
After evaluation by house doctor, ENT was called to re-evaluate.
There exam showed increased swelling and pus in the posterior
oropharynx. Her O2 sat dropped to 90% on RA which returned to
99% on 2L. She was given 1g of vancomycin and started on
Decadron 10mg iv q6h. She was transferred to the [**Hospital Unit Name 153**] for
continuous O2 monitoring. In the [**Hospital Unit Name 153**], patient did well with O2
sat >95% 2L, abx were switched to augmentin for epiglottitis,
flagyl for diverticulitis, and decadron. Patient was then
transferred to F2 for continuous O2 monitoring.
.
On the floor, the patient received continuous O2 sat monitoring.
After ENT saw her the morning of [**6-20**], noting improvement of her
epiglottitis the Decadron was discontinued. She was monitored
for the rest of the day, and her O2 sats were steady at 94-100%
on room air. The patient's diarrhea improved throughout the
admission, and by the time she was transferred to the floor, she
flet no abdominal pain.  She was given vaccinations for both H.
flu and Pneumococcus while inpatient. She was discharged on
Augmenting 875mg PO BID for 21 days, Flagyl 500mg PO TID for 21
days, and a total course of 5 days of fluconazole.
.
She was given phone numbers to make follow up appointments with
Dr. [**Last Name (STitle) 6633**] (surgery), Dr. [**Last Name (STitle) 3878**] (ENT), and Dr. [**Last Name (STitle) **] (primary
care).

Medications on Admission:
Amox/clav 875 x [**5-20**]
Percocet prn
Lidocaine viscous
Ibuprofen
Estring

Discharge Medications:
1. Pramoxine-Mineral Oil-Zinc 1-12.5 % Ointment Sig: One (1)
Appl Rectal [**Hospital1 **] (2 times a day) as needed.
Disp:*1 bottle* Refills:*0*
2. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours).
Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
3. Amoxicillin-Pot Clavulanate 875-125 mg Tablet Sig: One (1)
Tablet PO BID (2 times a day) for 21 days.
Disp:*42 Tablet(s)* Refills:*0*
4. Fluconazole 200 mg Tablet Sig: One (1) Tablet PO Q24H (every
24 hours) for 3 days.
Disp:*3 Tablet(s)* Refills:*0*
5. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3
times a day) for 21 days.
Disp:*63 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Epiglottitis, diverticulitis, [**Female First Name (un) 564**] infection


Discharge Condition:
Stable, satting well on room air, tolerating PO.


Discharge Instructions:
Please take all of your medications as instructed. If you
experience a sore throat, difficulty swallowing, pain
swallowing, fever, difficulty breathing, or any other concerning
symptoms, please seek medical advice immediately.

Followup Instructions:
Please set up an appointment with Dr. [**Last Name (STitle) 3878**] [**Telephone/Fax (1) 2349**] for
ENT follow up.

Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) 3628**] SURGICAL ASSOC [**Name11 (NameIs) 3628**]-3A (SB)
Date/Time:[**2151-6-30**] 4:30
Provider: [**Name10 (NameIs) **] [**Last Name (NamePattern4) 2163**], MD Phone:[**Telephone/Fax (1) 1954**]
Date/Time:[**2151-8-4**] 4:30
Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD Phone: [**Telephone/Fax (1) 250**] Date/Time:
[**2151-7-16**] 11:00
Provider: [**Name Initial (NameIs) **] SUITE GI ROOMS Date/Time:[**2151-7-21**] 2:00
{'Acute epiglottitis without mention of obstruction,Candidiasis of mouth,Diverticulitis of colon (without mention of hemorrhage),Esophageal reflux,Vaginitis and vulvovaginitis, unspecified,Spondylosis of unspecified site, without mention of myelopathy'}


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: Pain with swallowing, hoarse voice, admitted after ENT saw
epiglottitis on laryngoscopy

PRESENT ILLNESS: 66 yo F w/ recent diverticulitis p/w dysphagia x 5d. Pt had
otherwise been completely healthy until mid-[**Month (only) **], when developed
abdominal pain and diarrhea. She was hospitlaized in [**Location (un) **],
[**Location (un) **], where [**Doctor Last Name **] had been living for several months. There,
she had a negative C. diff and CT abd/pelvis showed
diverticulitis. She was treated with amox/clavulnate since then
to finish a 4-week course. Since then she has had
near-resolution of the abdominal pain and diarrhea. 5 days ago
she developed acute sore throat. It progressively got worse
until she was seen in the ED [**2151-6-13**], where monospot was sent and
was negative, and given the number for outpt ENT, where she was
seen [**2151-6-14**]. Laryngoscopy showed epiglottitis. She was sent to
the [**Hospital Ward Name **] for direct admission, and then ENT suggested she
be admitted to the ICU for continuous O2 sat monitoring.

MEDICAL HISTORY: Diverticulitis recently
Chronic back pain secondary to spondylosis
Arthritis
s/p appendectomy, cholecystectomy, tonsillectomy, tubal ligation
GERD

MEDICATION ON ADMISSION: Amox/clav 875 x [**5-20**]
Percocet prn
Lidocaine viscous
Ibuprofen
Estring

ALLERGIES: Nsaids

PHYSICAL EXAM: T 98.8, BP 128/84, P 97, RR 20, O2 96% RA
GEN: Well nourished, pleasant
HEENT: PERRL, EOMI, MMM, erythematous posterior OP
CV: RRR normal S1/S2
PULM: CTA, no stridor, no wheeze
ABD: NABS s/nd/nt
EXTR: No c/c/e, 2+ DP
NEURO: AAOx3, nonfocal

FAMILY HISTORY: No DM, CAD, HTN. MGM and PGF with colon CA. Fathre died
secondary to aortic aneurysm.

SOCIAL HISTORY: No sick contacts. History of tobacco, quit at age 50. occasional
EtOH, no IVDU. Lives with husband, has 2 children. Teaches one
class at [**University/College 5130**]. Was at [**Location (un) **] working on a book.
Independent ADL's. 

### Response:
{'Acute epiglottitis without mention of obstruction,Candidiasis of mouth,Diverticulitis of colon (without mention of hemorrhage),Esophageal reflux,Vaginitis and vulvovaginitis, unspecified,Spondylosis of unspecified site, without mention of myelopathy'}
