CHIEF COMPLAINT: Pharyngitis

PRESENT ILLNESS: 33 yo M with PMHx GERD and recurrent pharyngitis presented to ED
after seeeing PCP for sore throat and fevers for 1 day. Of note,
patient had ICU admission [**9-/2183**] for sepsis like syndrome.
Patient saw PCP who did strep cultures and neck plain film which
preliminarily was read as epiglottis so she sent him to ED.
.
In the ED, initial VS: 98.4 94/53 98 18 99%Ra. Given 10 of
decadron, 30mg of toradol, 5mg of roxicet, 600 IV clindamycin,
and 1.5L NS. ENT saw him and said airway patent and that he
didn't have signs or symptoms of epiglottis. VS 99.4 107 118/77
18 100% RA.
.
Currently, patient complained of sore throat and chills. He
endorsed getting phayrngitis 5 times per year for life. He was
also complaining of total back pain. He received liquid tylenol
and then vomited. Also complained of being hungry. Denies any
new recent sexual partner.
.
ROS: Denies night sweats, headache, vision changes, rhinorrhea,
congestion, cough, shortness of breath, chest pain, abdominal
pain, nausea, vomiting, diarrhea, constipation, BRBPR, melena,
hematochezia, dysuria, hematuria.

MEDICAL HISTORY: 1. Dyspepsia with negative EGD in [**2176**], was treated for H.
pylori, has been treated with maintenance omeprazole.
2. Back pain, no recurrence since [**2177**].
3. Episode of a presumed viral illness with sepsis syndrome
[**9-23**]
4. [**Doctor Last Name 13534**]-Parkinson-White pattern

MEDICATION ON ADMISSION: Prilosec

ALLERGIES: Penicillins

PHYSICAL EXAM: T 101.3 131 145/117 20 100% RA

FAMILY HISTORY: Father with diabetes, mother with her irregular
heartbeat.

SOCIAL HISTORY: SOCIAL HISTORY: Married, has a 3-year-old boy. Works for
Limousine Company. No smoking, no alcohol, no drugs of abuse.
He is planning travel to [**Country 3400**] in [**Month (only) 216**] of this year.
Streptococcal sore throat
Strep sore throat
Admission Date:  [**2184-9-6**]              Discharge Date:   [**2184-9-7**]

Date of Birth:  [**2151-1-20**]             Sex:   M

Service: MEDICINE

Allergies:
Penicillins

Attending:[**First Name3 (LF) 3561**]
Chief Complaint:
Pharyngitis

Major Surgical or Invasive Procedure:
None


History of Present Illness:
33 yo M with PMHx GERD and recurrent pharyngitis presented to ED
after seeeing PCP for sore throat and fevers for 1 day. Of note,
patient had ICU admission [**9-/2183**] for sepsis like syndrome.
Patient saw PCP who did strep cultures and neck plain film which
preliminarily was read as epiglottis so she sent him to ED.
.
In the ED, initial VS: 98.4 94/53 98 18 99%Ra. Given 10 of
decadron, 30mg of toradol, 5mg of roxicet, 600 IV clindamycin,
and 1.5L NS. ENT saw him and said airway patent and that he
didn't have signs or symptoms of epiglottis. VS 99.4 107 118/77
18 100% RA.
.
Currently, patient complained of sore throat and chills. He
endorsed getting phayrngitis 5 times per year for life. He was
also complaining of total back pain. He received liquid tylenol
and then vomited. Also complained of being hungry. Denies any
new recent sexual partner.
.
ROS: Denies night sweats, headache, vision changes, rhinorrhea,
congestion, cough, shortness of breath, chest pain, abdominal
pain, nausea, vomiting, diarrhea, constipation, BRBPR, melena,
hematochezia, dysuria, hematuria.


Past Medical History:
1. Dyspepsia with negative EGD in [**2176**], was treated for H.
pylori, has been treated with maintenance omeprazole.
2. Back pain, no recurrence since [**2177**].
3. Episode of a presumed viral illness with sepsis syndrome
[**9-23**]
4. [**Doctor Last Name 13534**]-Parkinson-White pattern


Social History:

SOCIAL HISTORY: Married, has a 3-year-old boy. Works for
Limousine Company. No smoking, no alcohol, no drugs of abuse.
He is planning travel to [**Country 3400**] in [**Month (only) 216**] of this year.


Family History:
Father with diabetes, mother with her irregular
heartbeat.


Physical Exam:
T 101.3 131 145/117 20 100% RA

General Appearance: Well nourished

Eyes / Conjunctiva: PERRL, Pupils dilated

Head, Ears, Nose, Throat: Normocephalic, enlarged tonsils with
peritonsillar edema and tonsillar exudates

Lymphatic: Cervical WNL, Supraclavicular WNL, tender nodes

Cardiovascular: (S1: Normal), (S2: Normal), S3

Peripheral Vascular: (Right radial pulse: Not assessed), (Left
radial pulse: Not assessed), (Right DP pulse: Present), (Left DP
pulse: Present)

Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds:
Clear : )

Abdominal: Soft, Non-tender, Bowel sounds present, No(t) Tender:


Extremities: Right lower extremity edema: Absent, Left lower
extremity edema: Absent

Skin:  Not assessed

Neurologic: Attentive, Follows simple commands, Responds to: Not
assessed, Oriented (to): person, place and time, Movement:
Purposeful, Tone: Not assessed


Pertinent Results:
[**2184-9-6**] 04:00PM BLOOD WBC-16.2* RBC-5.18 Hgb-13.6* Hct-41.1
MCV-79* MCH-26.3* MCHC-33.2 RDW-13.6 Plt Ct-223
[**2184-9-6**] 06:20PM BLOOD WBC-17.0* RBC-5.17 Hgb-13.5* Hct-40.5
MCV-79* MCH-26.1* MCHC-33.3 RDW-13.5 Plt Ct-206
[**2184-9-7**] 05:23AM BLOOD WBC-20.6* RBC-4.81 Hgb-12.5* Hct-37.5*
MCV-78* MCH-26.0* MCHC-33.3 RDW-13.6 Plt Ct-209
[**2184-9-6**] 06:20PM BLOOD Glucose-126* UreaN-10 Creat-1.2 Na-139
K-3.8 Cl-103 HCO3-25 AnGap-15
[**2184-9-7**] 05:23AM BLOOD Glucose-155* UreaN-7 Creat-0.9 Na-141
K-3.9 Cl-106 HCO3-22 AnGap-17
[**2184-9-7**] 05:23AM BLOOD Calcium-8.4 Phos-3.0# Mg-1.7
[**2184-9-6**] 06:20PM BLOOD Lactate-2.2* K-3.8

Monospot negative

Throat: OP flora, culture pending
                          **FINAL REPORT [**2184-9-8**]**

   THROAT - R/O BETA STREP (Final [**2184-9-8**]):
      BETA STREPTOCOCCUS GROUP A.    SPARSE GROWTH.
      BETA STREPTOCOCCI, NOT GROUP A.    SPARSE GROWTH.

   RESPIRATORY CULTURE (Final [**2184-9-8**]):
      MODERATE GROWTH Commensal Respiratory Flora.
      BETA STREPTOCOCCUS GROUP A.    MODERATE GROWTH.


Brief Hospital Course:
Pharyngitis:

The patient was admitted to the medical ICU for close
monitoring. He was treated in the ED with decadron and
clindamycin/ceftriaxone. He was seen by ENT, who did a visual
exam and found to evidence of epiglottitis. He was continued on
antibiotics in the ICU, and remained clinically stable. Given
his stable symptoms and his ability to eat and walk, he was
discharged to follow up with the ID service and ENT as an
outpatient.


Medications on Admission:
Prilosec

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
2. Clindamycin HCl 300 mg Capsule Sig: One (1) Capsule PO every
six (6) hours for 10 days.
Disp:*40 Capsule(s)* Refills:*0*
3. Vicodin 5-500 mg Tablet Sig: 1-2 Tablets PO every six (6)
hours as needed for fever or pain for 10 days: do not take with
any other acetamenophen (tylenol) . Do not drive. .
Disp:*30 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Acute Pharyngitis


Discharge Condition:
Stable, improved symptoms on antibiotics and steroids.


Discharge Instructions:
You were admitted for pharyngitis, a in infection of your
throat. This appeared to be bacterial, and you were placed on
antibiotics to complete a 10 day course.

Your antibiotics are:
Clindamycin 300mg by mouth three times daily.

If you develop shortness of breath or worsening symptoms, please
return to the hospital.

Followup Instructions:
Please follow-up with ENT by arranging an appointment with them
at: ([**Telephone/Fax (1) 6213**]

Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5377**], MD Phone:[**Telephone/Fax (1) 250**]
Date/Time:[**2184-9-15**] 9:00

Provider: [**First Name8 (NamePattern2) 4021**] [**Name11 (NameIs) **], MD [**First Name (Titles) **] [**Last Name (Titles) 2228**]
Phone:[**Telephone/Fax (1) 457**] Date/Time:[**2184-9-20**] 3:30

You also have the following appointment:
Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1008**], M.D. Phone:[**Telephone/Fax (1) 62**]
Date/Time:[**2184-10-29**] 4:00
{'Streptococcal sore throat'}


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: Pharyngitis

PRESENT ILLNESS: 33 yo M with PMHx GERD and recurrent pharyngitis presented to ED
after seeeing PCP for sore throat and fevers for 1 day. Of note,
patient had ICU admission [**9-/2183**] for sepsis like syndrome.
Patient saw PCP who did strep cultures and neck plain film which
preliminarily was read as epiglottis so she sent him to ED.
.
In the ED, initial VS: 98.4 94/53 98 18 99%Ra. Given 10 of
decadron, 30mg of toradol, 5mg of roxicet, 600 IV clindamycin,
and 1.5L NS. ENT saw him and said airway patent and that he
didn't have signs or symptoms of epiglottis. VS 99.4 107 118/77
18 100% RA.
.
Currently, patient complained of sore throat and chills. He
endorsed getting phayrngitis 5 times per year for life. He was
also complaining of total back pain. He received liquid tylenol
and then vomited. Also complained of being hungry. Denies any
new recent sexual partner.
.
ROS: Denies night sweats, headache, vision changes, rhinorrhea,
congestion, cough, shortness of breath, chest pain, abdominal
pain, nausea, vomiting, diarrhea, constipation, BRBPR, melena,
hematochezia, dysuria, hematuria.

MEDICAL HISTORY: 1. Dyspepsia with negative EGD in [**2176**], was treated for H.
pylori, has been treated with maintenance omeprazole.
2. Back pain, no recurrence since [**2177**].
3. Episode of a presumed viral illness with sepsis syndrome
[**9-23**]
4. [**Doctor Last Name 13534**]-Parkinson-White pattern

MEDICATION ON ADMISSION: Prilosec

ALLERGIES: Penicillins

PHYSICAL EXAM: T 101.3 131 145/117 20 100% RA

FAMILY HISTORY: Father with diabetes, mother with her irregular
heartbeat.

SOCIAL HISTORY: SOCIAL HISTORY: Married, has a 3-year-old boy. Works for
Limousine Company. No smoking, no alcohol, no drugs of abuse.
He is planning travel to [**Country 3400**] in [**Month (only) 216**] of this year. 

### Response:
{'Streptococcal sore throat'}
