CHIEF COMPLAINT: cough, fever

PRESENT ILLNESS: Mrs. [**Known lastname **] is a 32 yo woman with no PMH who presented to the ED
with three days of cough and fever. She reports that her cough
was non-productive and that she had no hemoptysis.

MEDICAL HISTORY: None

MEDICATION ON ADMISSION: none

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals: T: 99.5 BP: 104/79 P: 98 R: 15 SaO2: 96% RA
General: Awake, alert, NAD, pleasant, appropriate, cooperative.

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: denies tobacco, alcohol, drug use
Unspecified septicemia,Pneumonia, organism unspecified,Sepsis
Septicemia NOS,Pneumonia, organism NOS,Sepsis
Admission Date:  [**2153-12-23**]              Discharge Date:   [**2153-12-23**]

Date of Birth:  [**2120-12-27**]             Sex:   F

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 5893**]
Chief Complaint:
cough, fever

Major Surgical or Invasive Procedure:
none


History of Present Illness:
Mrs. [**Known lastname **] is a 32 yo woman with no PMH who presented to the ED
with three days of cough and fever. She reports that her cough
was non-productive and that she had no hemoptysis.

She saw her PCP on the day of presentation, who prescribed her
azithromycin. After taking the first dose, however, she had
three loose stools, and so she presented to the [**Hospital1 18**] ED.

In the ED, her initial VSs were 102.2, 148, 130/79 18 98% on RA.
She received 4 L NS and levofloxacin 750 mg IV and was
transferred to the [**Hospital Unit Name 153**] for futher care.

In the [**Hospital Unit Name 153**], her only other complaint is of some mild chest pain
with coughing.


Past Medical History:
None

Social History:
denies tobacco, alcohol, drug use

Family History:
non-contributory

Physical Exam:
Vitals: T: 99.5 BP: 104/79 P: 98 R: 15 SaO2: 96% RA
General: Awake, alert, NAD, pleasant, appropriate, cooperative.

HEENT: no scleral icterus, MMM, no lesions noted in OP
Neck: supple, no significant LAD
Pulmonary: left lower lung field crackels, no wheezes or ronchi
Cardiac: RR, nl S1 S2, no murmurs, rubs or gallops appreciated
Abdomen: soft, NT, ND, normoactive bowel sounds, no masses or
organomegaly noted
Extremities: No edema, 2+ radial, DP pulses b/l


Pertinent Results:
[**2153-12-22**] 11:20PM   WBC-3.4* RBC-3.79* HGB-11.4* HCT-33.1* MCV-87
MCH-30.1 MCHC-34.4 RDW-13.0
[**2153-12-22**] 11:20PM   NEUTS-47* BANDS-46* LYMPHS-6* MONOS-1* EOS-0
BASOS-0 ATYPS-0 METAS-0 MYELOS-0
[**2153-12-22**] 11:20PM   PLT COUNT-161
[**2153-12-22**] 10:10PM URINE  COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.017
[**2153-12-22**] 10:10PM URINE  BLOOD-LG NITRITE-NEG PROTEIN-TR
GLUCOSE-TR KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG
[**2153-12-22**] 10:10PM URINE  RBC-[**3-5**]* WBC-[**3-5**] BACTERIA-FEW YEAST-NONE
EPI-0-2
[**2153-12-22**] 11:20PM   GLUCOSE-125* UREA N-9 CREAT-0.7 SODIUM-139
POTASSIUM-3.5 CHLORIDE-109* TOTAL CO2-22 ANION GAP-12
[**2153-12-22**] 11:48PM   LACTATE-2.4*
[**2153-12-23**] 02:36AM   LACTATE-1.3
[**2153-12-23**] 11:56AM   WBC-4.9 RBC-3.55* HGB-10.4* HCT-31.0* MCV-87
MCH-29.2 MCHC-33.5 RDW-12.7
[**2153-12-23**] 11:56AM   NEUTS-78* BANDS-11* LYMPHS-10* MONOS-1* EOS-0
BASOS-0 ATYPS-0 METAS-0 MYELOS-0
[**2153-12-23**] 11:56AM   PLT COUNT-129*

[**2153-12-22**] Chest Xray: Left lower lobe pneumonia.


Brief Hospital Course:
Ms. [**Known lastname **] is a 32 yo woman admitted with LLL pneumonia and evidence
of systemic inflammatory response on admission with hypotension,
fever, bandemia.

1)Left lower lobe pneumonia: Seen on chest xray, responded well
to initiation of IV antibiotics and IV fluids.  Initially she
had a bandemia which improved on repeat following antibiotics.
She remained afebrile on the day of admission with stable blood
pressure.  She had no respiratory distress and had a low PORT
score.  She was discharged on the day of admission to complete a
7 day course of levofloxacin 750mg po.  She was instructed to
follow up with her primary care doctor in [**1-2**] weeks and to
return to the hospital if her symptoms do not continue to
improve.

2)Hypotension - she was transiently hypotensive in ED with SBP
80's-90's, unclear baseline blood pressure.  She was given 4L NS
and remained normotensive with resolution of tachycardia.
Hypotension likely due to early systemic inflammatory response
which resolved with IV levofloxacin.

3) Code status: FULL CODE

Medications on Admission:
none

Discharge Medications:
1. Levofloxacin 750 mg Tablet Sig: One (1) Tablet PO once a day
for 6 days: Please take all of this prescription.  Do not stop
early even if you are feeling better.  .
Disp:*6 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Left lower lobe pneumonia


Discharge Condition:
fair


Discharge Instructions:
You were admitted to the hospital because you have a bad
pneumonia which caused low blood pressure and high fever.  You
were treated with antibiotics and intravenous fluids.

It is very important that you take the antibiotics as prescribed
for a total of 7 days to treat the pneumonia.

You should follow up with your primary care doctor within [**1-2**]
weeks to be sure that the pneumonia is fully treated and to have
a repeat chest xray.

You should call your doctor or go to the emergency department if
you experience fever >100.4, light headedness or fainting,
worsening cough or any other concerning symptoms.

Followup Instructions:
Please call your primary care doctor [**First Name (Titles) **] [**Last Name (Titles) **] an appointment
to follow up within 1-2 weeks.
{'Unspecified septicemia,Pneumonia, organism unspecified,Sepsis'}


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: cough, fever

PRESENT ILLNESS: Mrs. [**Known lastname **] is a 32 yo woman with no PMH who presented to the ED
with three days of cough and fever. She reports that her cough
was non-productive and that she had no hemoptysis.

MEDICAL HISTORY: None

MEDICATION ON ADMISSION: none

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals: T: 99.5 BP: 104/79 P: 98 R: 15 SaO2: 96% RA
General: Awake, alert, NAD, pleasant, appropriate, cooperative.

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: denies tobacco, alcohol, drug use 

### Response:
{'Unspecified septicemia,Pneumonia, organism unspecified,Sepsis'}
