CHIEF COMPLAINT: 

PRESENT ILLNESS: Baby Girl [**Known lastname 70899**] is a 34 and [**2-14**]
week, 2520 gram female newborn who was admitted to the
neonatal intensive care unit for management of prematurity.
The infant was born to a 37-year-old gravida [**Month/Day (4) 1105**], para II,
now [**Name (NI) 1105**] mother with prenatal screens blood type O positive,
antibody negative, hepatitis B surface antigen negative, RPR
nonreactive, rubella immune, group B strep status unknown.
[**Hospital 37544**] medical history of asthma maintained on albuterol
and Flovent. Other maternal medications include prenatal
vitamins. Previous pregnancies resulted in 2 full term
infants in [**2125**], and [**2126**]. This pregnancy was complicated by
pregnancy induced hypertension beginning around 28 weeks
gestation. Preeclampsia laboratory monitoring without
concerns. Maternal fetal medicine involved in care and mother
underwent close monitoring with a nonstress test and
biophysical profiles. About 1 week history of nonreactive
nonstress test but this would be followed by reactivity. A
betamethasone was complete on [**2-26**]. Today's monitoring
revealed a biophysical profile of 8 out of 8 and AFI of 29
(polyhydramnios), and MCA Doppler flow of 1.5. There was
increased MCA flow that prompted decision for delivery. Of
additional note, father reported a viral like illness in mom
approximately 3 weeks prior to delivery. Dr. [**Last Name (STitle) **] informed
the neonatal intensive care unit team at delivery that CMV,
toxo and Parvovirus titers were all negative. The remainder
of the family history is noncontributory. Delivery of this
infant was by cesarean section for nonreassuring fetal heart
tracing. Mother received spinal anesthesia. Positive meconium
stained amniotic fluid. Apgar scores were 8 at one and 9 at
five minutes of age, respectively.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Other preterm infants, 2,500 grams and over,Observation for suspected infectious condition,Need for prophylactic vaccination and inoculation against viral hepatitis
Preterm NEC 2500+g,NB obsrv suspct infect,Need prphyl vc vrl hepat
Unit No:  [**Numeric Identifier 70902**]
Admission Date: [**2134-3-4**]
Discharge Date: [**2134-4-4**]
Date of Birth:  [**2134-3-4**]
Sex:  F
Service:  Neonatology


HISTORY OF PRESENT ILLNESS:  Baby Girl [**Known lastname 70899**] is a 34 and [**2-14**]
week, 2520 gram female newborn who was admitted to the
neonatal intensive care unit for management of prematurity.
The infant was born to a 37-year-old gravida [**Month/Day (4) 1105**], para II,
now [**Name (NI) 1105**] mother with prenatal screens blood type O positive,
antibody negative, hepatitis B surface antigen negative, RPR
nonreactive, rubella immune, group B strep status unknown.
[**Hospital 37544**] medical history of asthma maintained on albuterol
and Flovent. Other maternal medications include prenatal
vitamins. Previous pregnancies resulted in 2 full term
infants in [**2125**], and [**2126**]. This pregnancy was complicated by
pregnancy induced hypertension beginning around 28 weeks
gestation. Preeclampsia laboratory monitoring without
concerns. Maternal fetal medicine involved in care and mother
underwent close monitoring with a nonstress test and
biophysical profiles. About 1 week history of nonreactive
nonstress test but this would be followed by reactivity. A
betamethasone was complete on [**2-26**]. Today's monitoring
revealed a biophysical profile of 8 out of 8 and AFI of 29
(polyhydramnios), and MCA Doppler flow of 1.5. There was
increased MCA flow that prompted decision for delivery. Of
additional note, father reported a viral like illness in mom
approximately 3 weeks prior to delivery. Dr. [**Last Name (STitle) **] informed
the neonatal intensive care unit team at delivery that CMV,
toxo and Parvovirus titers were all negative. The remainder
of the family history is noncontributory. Delivery of this
infant was by cesarean section for nonreassuring fetal heart
tracing. Mother received spinal anesthesia. Positive meconium
stained amniotic fluid. Apgar scores were 8 at one and 9 at
five minutes of age, respectively.

PHYSICAL EXAMINATION:  Birth weight was 2520 grams greater
than 75th percentile, length 46 cm, 50th to 75th percentile,
head circumference 31.5 cm, 50th percentile. Pink well
appearing infant in no acute distress. Anterior fontanelle
soft and flat. Difficulty with keeping eyes open to assess
red reflex. Ears normal set, dull slightly edematous. Intact
palate. Good suck. Neck supple. Intact clavicles. Lungs
slightly coarse bilaterally but good and equal aeration.
Heart regular rate and rhythm, no murmurs, +2 femoral pulses.
Abdomen soft, positive bowel sounds, no hepatosplenomegaly, 3
vessel cord, meconium stained. GU: Normal preterm female.
Patent anus. No sacral anomalies. Hips stable. Extremities
pink and well perfused. At delivery, extremities felt
slightly taunt and edematous though currently appear
improved.

HOSPITAL COURSE:  Respiratory: The infant has been in room
air for her entire newborn intensive care unit admission. She
has not required any supplemental oxygen and has not had any
notable apnea of prematurity.

Cardiovascular: The infant's blood pressure has been stable
throughout her hospitalization. No murmurs have been
auscultated. Heart rate has been consistently in the 120 to
160 range.

Fluid, electrolytes and nutrition: At the time of admission
to the newborn intensive care unit, the infant was started on
IV fluids of D10W at 80 cc/kilo/day by way of peripheral IV.
Her initial D-sticks were 20 and 36 and she did receive 2 D10
boluses for these hypoglycemic events. The infant remained
NPO and it was noted on day of life 2 that her stools
contained frank blood. KUB was done at this time and found to
be nonspecific. She continued to have KUBs every 4-6 hours
which continued to be nonspecific in appearance. On day of
life 3, her repogle tube was placed and put to low continuous
suction. She has remained NPO receiving PN and Intralipid
well at peripheral IV. Of note, from day of life 5 to day of
life 7, it was noted that her repogle tube  output had
increased from 5 to 12 cc of very dark green bilious drainage
and an abdominal ultrasound was obtained on [**3-11**], which
showed normal placement of mesenteric arteries with no
malrotation. On [**3-12**], the infant was transferred to
[**Hospital3 1810**] for  Broviac placement and upper GI and a
small bowel follow through which were read as normal. The
infant was medically treated for necrotizing enterocolitis.
She completed her 14 days of bowel rest with 14 days of Zosyn.
On day of life 17, enteral feeds began of Nutramigen 20
calories and, on day of life 22, full enteral feeds of 150
kilo/day of breast milk. She is currently feeding adlib
amounts of expressed breastmilk made up to 24 calories with
Neosure powder. Calories were added for poor weight gain on 20
cal breastmilk.

Gastrointestinal: Peak bilirubin on day of life 3 was
5.4/0.3. She has not required any phototherapy.

Hematology: This infant's blood type is not known at this
time. She has not received any blood products during her stay
in the newborn intensive care unit.

Infectious disease: Upon admission to the newborn intensive
care unit, CBC with differential and blood cultures were
drawn. White blood cell initially 36.3 with a hematocrit of
40.4 with 49 polys, 2% bands, and a platelet count of
483,000. She was placed on ampicillin and gentamicin upon
admission to the newborn intensive care unit. A repeat white
count on day of life 2 was 33 with 50% polys and 3% bands.
Given her presentation of bloody stool on day of life 2, it
was decided to treat her with a course of antibiotics. On day
of life 4, she was switched from ampicillin and gentamicin to
Zosyn and the infant completed her 14 day course. Stool
cultures were also sent on day of life 4 for salmonella,
shigella, C. Difficile and all those cultures are negative.

Neurology: Head ultrasound is not indicated for this 34 and
[**2-14**] weeker.

Sensory: Audiology screening pending.

Ophthalmology examination is not indicated at this
gestational age.

Immunizations: Hepatitis B on [**2134-3-26**].


    State newborn screening: The first State newborn
    screening was sent at 72 hours of age. Results came back
    on [**3-18**], of slightly elevated for PKU and this was
    thought to be secondary to the TPN. Repeat
    State newborn screen status sent on [**3-29**], and
    results were normal.

F/U at [**Location (un) 2274**]/CAM, Dr. [**Last Name (STitle) 21615**] within in 5
 days of discharge.
VNA to come to home day post discharge.

DISCHARGE DIAGNOSES:
1.  Prematurity at 34 and [**2-14**] week gestation.
2.  Rule out sepsis.
3.  Rule out necrotizing colitis.
4.  Rule out gastrointestinal obstruction.


F/U at [**Location (un) 2274**]/CAM, Dr. [**Last Name (STitle) 70903**] within 5 days of discharge. VNA
to go to home day post discharge.
                        [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 37691**], [**MD Number(1) 55783**]

Dictated By:[**Last Name (NamePattern1) 67981**]
MEDQUIST36
D:  [**2134-4-1**] 16:17:05
T:  [**2134-4-1**] 19:17:16
Job#:  [**Job Number 70904**]
{'Other preterm infants, 2,500 grams and over,Observation for suspected infectious condition,Need for prophylactic vaccination and inoculation against viral hepatitis'}


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: 

PRESENT ILLNESS: Baby Girl [**Known lastname 70899**] is a 34 and [**2-14**]
week, 2520 gram female newborn who was admitted to the
neonatal intensive care unit for management of prematurity.
The infant was born to a 37-year-old gravida [**Month/Day (4) 1105**], para II,
now [**Name (NI) 1105**] mother with prenatal screens blood type O positive,
antibody negative, hepatitis B surface antigen negative, RPR
nonreactive, rubella immune, group B strep status unknown.
[**Hospital 37544**] medical history of asthma maintained on albuterol
and Flovent. Other maternal medications include prenatal
vitamins. Previous pregnancies resulted in 2 full term
infants in [**2125**], and [**2126**]. This pregnancy was complicated by
pregnancy induced hypertension beginning around 28 weeks
gestation. Preeclampsia laboratory monitoring without
concerns. Maternal fetal medicine involved in care and mother
underwent close monitoring with a nonstress test and
biophysical profiles. About 1 week history of nonreactive
nonstress test but this would be followed by reactivity. A
betamethasone was complete on [**2-26**]. Today's monitoring
revealed a biophysical profile of 8 out of 8 and AFI of 29
(polyhydramnios), and MCA Doppler flow of 1.5. There was
increased MCA flow that prompted decision for delivery. Of
additional note, father reported a viral like illness in mom
approximately 3 weeks prior to delivery. Dr. [**Last Name (STitle) **] informed
the neonatal intensive care unit team at delivery that CMV,
toxo and Parvovirus titers were all negative. The remainder
of the family history is noncontributory. Delivery of this
infant was by cesarean section for nonreassuring fetal heart
tracing. Mother received spinal anesthesia. Positive meconium
stained amniotic fluid. Apgar scores were 8 at one and 9 at
five minutes of age, respectively.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Other preterm infants, 2,500 grams and over,Observation for suspected infectious condition,Need for prophylactic vaccination and inoculation against viral hepatitis'}
