CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 47 year-old
female with a history of diabetes, hypertension, asthma and
heavy alcohol use who is admitted with facial cellulitis as
well as alcohol withdraw.  The patient was well until
Thursday [**2-19**] when she awoke the following morning.  She was
feeling ill and confused.  Her roommate was concerned and he
took her to the Emergency Room for evaluation.  At that time
she started developing some pain in her face, which quickly
progressed into facial cellulitis that started spreading and
the patient became unable to open her eyes while she was in
the Emergency Department.  At that time she also reported
feeling chills and feverish since this has happened.
However, she was denying fevers or chills the day prior to
admission.  The patient denies any history of trauma.  She
has not been swimming or in any pools.  She has no pets that
could have scratched her in the face.  Otherwise she is not
complaining of any shortness of breath, chest pain, abdominal
pain.  No nausea or vomiting.  The patient also reports a
history of drinking heavily and the last time she had a drink
was the day prior to admission.

MEDICAL HISTORY: 1.  Diabetes.  2.  Hypertension.  3.
Asthma.  4.  History of alcohol abuse.  5.
Depression/anxiety.  6.  Liver cirrhosis.

MEDICATION ON ADMISSION: Klonopin 1 mg po b.i.d., Zestril
20 mg po q day, Advair one puff po b.i.d., Flovent two puffs
po b.i.d., Albuterol MDI prn, Serevent, Humulin insulin 45
units q.a.m., 30 units q.p.m., Prilosec 20 mg po q day,
Theophylline 300 mg po b.i.d. and Fluoxetine 20 mg po q day.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient has a positive history of
alcohol abuse and she continues to smoke tobacco half pack
per day.
Cellulitis and abscess of face,Erysipelas,Alcohol withdrawal,Cirrhosis of liver without mention of alcohol,Alcoholic cardiomyopathy,Other and unspecified alcohol dependence, continuous,Asthma, unspecified type, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled
Cellulitis of face,Erysipelas,Alcohol withdrawal,Cirrhosis of liver NOS,Alcoholic cardiomyopathy,Alcoh dep NEC/NOS-contin,Asthma NOS,DMII wo cmp nt st uncntr
Admission Date:  [**2150-2-21**]     Discharge Date:  [**2150-2-27**]

Date of Birth:   [**2102-5-27**]     Sex:  F

Service:

HISTORY OF PRESENT ILLNESS:  The patient is a 47 year-old
female with a history of diabetes, hypertension, asthma and
heavy alcohol use who is admitted with facial cellulitis as
well as alcohol withdraw.  The patient was well until
Thursday [**2-19**] when she awoke the following morning.  She was
feeling ill and confused.  Her roommate was concerned and he
took her to the Emergency Room for evaluation.  At that time
she started developing some pain in her face, which quickly
progressed into facial cellulitis that started spreading and
the patient became unable to open her eyes while she was in
the Emergency Department.  At that time she also reported
feeling chills and feverish since this has happened.
However, she was denying fevers or chills the day prior to
admission.  The patient denies any history of trauma.  She
has not been swimming or in any pools.  She has no pets that
could have scratched her in the face.  Otherwise she is not
complaining of any shortness of breath, chest pain, abdominal
pain.  No nausea or vomiting.  The patient also reports a
history of drinking heavily and the last time she had a drink
was the day prior to admission.

PAST MEDICAL HISTORY:  1.  Diabetes.  2.  Hypertension.  3.
Asthma.  4.  History of alcohol abuse.  5.
Depression/anxiety.  6.  Liver cirrhosis.

MEDICATIONS ON ADMISSION:  Klonopin 1 mg po b.i.d., Zestril
20 mg po q day, Advair one puff po b.i.d., Flovent two puffs
po b.i.d., Albuterol MDI prn, Serevent, Humulin insulin 45
units q.a.m., 30 units q.p.m., Prilosec 20 mg po q day,
Theophylline 300 mg po b.i.d. and Fluoxetine 20 mg po q day.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  The patient has a positive history of
alcohol abuse and she continues to smoke tobacco half pack
per day.

HOSPITAL COURSE:  After progression of the facial cellulitis
in the Emergency Department, the patient was transferred to
the Medical Intensive Care Unit.  She was seen by
ophthalmology who felt that her examination was consistent
with preseptal bilateral cellulitis.  She had a CT scan,
which was also consistent with preseptal disease.  It also
showed some evidence of sinusitis particularly in the left
frontal, anterior ethmoid and maxillary sinuses right greater
then left.  Infectious disease was also consulted and they
suggested initial triple antibiotic therapy with Vancomycin,
Clindamycin and Levofloxacin.  Before antibiotics were
obtained blood cultures were taken as well as there were
cultures taken from several of the facial bulla as well as
her eye cultures.  She was also evaluated by plastics who
felt there was no acute issue at this time.

1.  Alcohol withdraw:  The patient began to go through
progressive withdraw throughout the first several days of her
hospital course.  She became agitated, tachycardic.  Her
mental status decreased.  She was started on Valium and a
CIWA scale and placed on thiamine and folate.

2.  Periorbital cellulitis:  She was continued on Vancomycin
and Clindamycin initially.  Levofloxacin was discontinued as
her cultures grew back beta strep group A as well as coag
positive staphylococcus, which was not differentiated at that
time.  She was eventually continued on Vancomycin alone and
then when her staph came back as being consistent with
Methacillin sensitive staph aureus she was switched to
intravenous Cephazolin and then she was changed to po Keflex.
 It was eventually decided to discharge her on a ten day
course of Dicloxacillin 500 mg po q six hours.  The patient's
facial skin became highly improved with markedly decreased
erythema and some residual hyperpigmentation across both
cheeks.

3.  Asthma:  The patient initially presented with significant
wheezing.  She was continued on her various inhalers and
nebulizers prn.  She eventually did not require the
nebulizers and her wheezing had improved and stabilized.

4.  Cardiovascular:  The patient had an episode of AVNRT
while she was in the Intensive Care Unit and she was started
on Diltiazem, however, she remained stable on telemetry with
no further events.  Because of hypotension her Diltiazem was
discontinued.  She remained on telemetry on the floor without
any further cardiac events.  She was restarted on Captopril,
which was changed to Lisinopril prior to discharge.

DISCHARGE STATUS:  Discharge to home.

DISCHARGE MEDICATIONS:  1.  Dicloxacillin 500 mg po q 6 hours
times ten days.  2.  Prozac 20 mg po q day.  3.  Lisinopril
10 mg po q day.  4.  Calcium carbonate 500 mg po t.i.d.  5.
Albuterol, Advair and Flovent inhalers per prior home
regimen.  6.  Humulin 45 units q.a.m., 30 units q.p.m.  7.
Prilosec 20 mg po q day.  8.  Klonopin 1 mg po b.i.d.  9.
Theophylline 300 mg po b.i.d.






                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3090**], M.D.
[**MD Number(1) 3091**]

Dictated By:[**Last Name (NamePattern1) 1203**]

MEDQUIST36

D:  [**2150-2-27**]  10:56
T:  [**2150-2-27**]  13:10
JOB#:  [**Job Number 11794**]


Name: [**Known lastname 158**],[**Known firstname 1658**]                Unit No: [**Unit Number 1659**]

Admission Date:  [**2150-2-21**]     Discharge Date:  [**2150-3-2**]

Date of Birth:   [**2102-5-27**]     Sex:  F

Service:

DISCHARGE SUMMARY ADDENDUM: Please see the prior discharge
summary for all other pertinent information. The patient was
planned to be discharged on [**2150-2-27**] however because there
was no rehabilitation bed available she remained in house for
three extra days. The remainder of her hospital course was
unremarkable. She was discharged on [**2150-3-2**] to [**Hospital 1660**]
Rehabilitation Center on the prior discharge medications.




                     DR.[**Last Name (STitle) 1661**],[**First Name3 (LF) 1662**] 12-869





Dictated By:[**Last Name (NamePattern1) 1663**]

MEDQUIST36

D:  [**2150-5-15**]  11:00
T:  [**2150-5-18**]  08:19
JOB#:  [**Job Number 1664**]
{'Cellulitis and abscess of face,Erysipelas,Alcohol withdrawal,Cirrhosis of liver without mention of alcohol,Alcoholic cardiomyopathy,Other and unspecified alcohol dependence, continuous,Asthma, unspecified type, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled'}


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: The patient is a 47 year-old
female with a history of diabetes, hypertension, asthma and
heavy alcohol use who is admitted with facial cellulitis as
well as alcohol withdraw.  The patient was well until
Thursday [**2-19**] when she awoke the following morning.  She was
feeling ill and confused.  Her roommate was concerned and he
took her to the Emergency Room for evaluation.  At that time
she started developing some pain in her face, which quickly
progressed into facial cellulitis that started spreading and
the patient became unable to open her eyes while she was in
the Emergency Department.  At that time she also reported
feeling chills and feverish since this has happened.
However, she was denying fevers or chills the day prior to
admission.  The patient denies any history of trauma.  She
has not been swimming or in any pools.  She has no pets that
could have scratched her in the face.  Otherwise she is not
complaining of any shortness of breath, chest pain, abdominal
pain.  No nausea or vomiting.  The patient also reports a
history of drinking heavily and the last time she had a drink
was the day prior to admission.

MEDICAL HISTORY: 1.  Diabetes.  2.  Hypertension.  3.
Asthma.  4.  History of alcohol abuse.  5.
Depression/anxiety.  6.  Liver cirrhosis.

MEDICATION ON ADMISSION: Klonopin 1 mg po b.i.d., Zestril
20 mg po q day, Advair one puff po b.i.d., Flovent two puffs
po b.i.d., Albuterol MDI prn, Serevent, Humulin insulin 45
units q.a.m., 30 units q.p.m., Prilosec 20 mg po q day,
Theophylline 300 mg po b.i.d. and Fluoxetine 20 mg po q day.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient has a positive history of
alcohol abuse and she continues to smoke tobacco half pack
per day. 

### Response:
{'Cellulitis and abscess of face,Erysipelas,Alcohol withdrawal,Cirrhosis of liver without mention of alcohol,Alcoholic cardiomyopathy,Other and unspecified alcohol dependence, continuous,Asthma, unspecified type, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled'}
