CHIEF COMPLAINT: Right oral mass

PRESENT ILLNESS: This is a 52- year old gentlman with history of HIV and AIDS
admitted with a rapidly growing oral mass on the right side
concerning for lymphoma vs. kaposi's vs. SCC.  The mass was
first noticed on prior hospitalization, while he was
aggressively being treated for refractory CD4 count.

MEDICAL HISTORY: AIDs (CD4 13, VL 363) diagnosed with HIV in [**2092**],
hemochromatosis, hemorroids, HBV

MEDICATION ON ADMISSION: 

ALLERGIES: Bactrim

PHYSICAL EXAM: alert and oriented x 3
RRR, no mrg
CTAB
S/NT/ND +bs
incision CDI wit stitches visible.  No erethema, minimal edema.
LE: no edema, +SCD's.

FAMILY HISTORY: h/o ETOH abuse with siblings and sons

SOCIAL HISTORY: Lives alone in an apartment on the [**Location (un) 448**] in [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 669**].
Has brother and 2 sons in the area who are supportive. Former
teamster who worked setting up expos. Divorced.
Herpetic gingivostomatitis,Human immunodeficiency virus [HIV] disease,Other postoperative infection,Cellulitis and abscess of face,Unspecified protein-calorie malnutrition,Chronic viral hepatitis B without mention of hepatic coma without mention of hepatitis delta,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation
Herpetic gingivostomat,Human immuno virus dis,Other postop infection,Cellulitis of face,Protein-cal malnutr NOS,Hpt B chrn wo cm wo dlta,Abn react-surg proc NEC
Admission Date:  [**2108-9-17**]              Discharge Date:   [**2108-9-22**]

Date of Birth:  [**2056-2-14**]             Sex:   M

Service: ENT

Allergies:
Bactrim

Attending:[**First Name3 (LF) 7729**]
Chief Complaint:
Right oral mass

Major Surgical or Invasive Procedure:
Excision of right mandibular mass


History of Present Illness:
This is a 52- year old gentlman with history of HIV and AIDS
admitted with a rapidly growing oral mass on the right side
concerning for lymphoma vs. kaposi's vs. SCC.  The mass was
first noticed on prior hospitalization, while he was
aggressively being treated for refractory CD4 count.

Past Medical History:
AIDs (CD4 13, VL 363) diagnosed with HIV in [**2092**],
hemochromatosis, hemorroids, HBV

Social History:
Lives alone in an apartment on the [**Location (un) 448**] in [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 669**].
Has brother and 2 sons in the area who are supportive. Former
teamster who worked setting up expos. Divorced.

Family History:
h/o ETOH abuse with siblings and sons

Physical Exam:
alert and oriented x 3
RRR, no mrg
CTAB
S/NT/ND +bs
incision CDI wit stitches visible.  No erethema, minimal edema.
LE: no edema, +SCD's.

Pertinent Results:
[**2108-9-20**] 04:34AM BLOOD Neuts-81* Bands-0 Lymphs-14* Monos-4
Eos-1 Baso-0 Atyps-0 Metas-0 Myelos-0
[**2108-9-21**] 07:40AM BLOOD Glucose-141* UreaN-19 Creat-0.7 Na-139
K-4.3 Cl-109* HCO3-23 AnGap-11
[**2108-9-21**] 07:40AM BLOOD ALT-36 AST-36 LD(LDH)-144 AlkPhos-101
TotBili-1.7*
[**2108-9-21**] 07:40AM BLOOD Albumin-3.4 Calcium-8.7 Phos-3.4 Mg-2.3

Brief Hospital Course:
This is a 52 year old man with HIV/AIDS noted on prior
hospitalization to have a rapidly growing Right oral mass
concerning for Kaposi's sarcoma.  Patient underwent
uncomplicated excisional biopsy of right mandibular alveolar
ridge tumor with primary closure as described in operative
report.  Patient's initial post-operative course was noteable
for difficulty swallowing.  The dysphagia was originally thought
to be secondary to incisional pain, however, the patient's pain
continued to persist.  A speech/swallow evaluation was obtained
on POD#2, which revealed aspiration, for which the patient was
made strictly NPO.  Patient was also noted to have facial
cellulitis. FOE at that time revealed bilateral AE fold edema,
right more than left, with epiglottis thickening and effacement
of the right piriform.  Patient was transferred to ICU for
continuous telemetry and oxygen monitoring.  ID was consulted
for increased antibiotic coverage, and unasyn was started.
Steroids were also begun to decrease edema.  Blood cultures were
obtained, and were still pending at discharge. By POD#3, edema
was decreased.  A repeat swallow study on POD#3 noted patient
was able to tolerate ground solids, and patient was started on
thin liquids, ground solids, and po meds.  ID recommendations
with regards to HAART, prophylactic antibiotics, and other
HIV/AIDS medications were all instituted.  Serial FOE's while
patient was in the ICU revealed resolution of edema and patient
was transferred to floor.  On POD#4, patient did have symptoms
of frequent, loose stools, for which c.diff assays were sent.
C.diff results were pending at discharge, however symptoms had
resolved with trial of imodium. By POD#5, patient's pain was
controlled on oral pain meds, he was ambulating well, and
tolerating ground solid diet without symptoms of dysphagia or
aspiration.  Per ID recs, patient was discharged on 14 day
course of augmentin.  Patient was discharged home with
instructions to contact ENT team if symptoms of loose bowel
movements returned.   Patient will follow up with both Dr.
[**Last Name (STitle) 1837**] and infectious disease doctor.

Discharge Medications:
1. Amoxicillin-Pot Clavulanate 875-125 mg Tablet Sig: One (1)
Tablet PO BID (2 times a day) for 2 weeks.
Disp:*28 Tablet(s)* Refills:*0*
2. Alprazolam 0.25 mg Tablet Sig: One (1) Tablet PO QHS (once a
day (at bedtime)).
3. Atazanavir Sulfate 150 mg Capsule Sig: Two (2) Capsule PO QD
(once a day).
4. Prochlorperazine 5 mg Tablet Sig: One (1) Tablet PO Q8H
(every 8 hours) as needed for nausea.
5. Dapsone 100 mg Tablet Sig: One (1) Tablet PO QD (once a day).

6. Loperamide HCl 2 mg Capsule Sig: One (1) Capsule PO QID (4
times a day) as needed for diarrhea.
7. Mirtazapine 30 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
8. Ritonavir 100 mg Capsule Sig: One (1) Capsule PO QD (once a
day).
9. Trazodone HCl 100 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime) as needed.
10. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs
PO Q4-6H (every 4 to 6 hours) as needed for pain.
11. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4-6H
(every 4 to 6 hours) as needed for Temp>101.5, pain.
12. Methylprednisolone 4 mg Tablet Sig: One (1) Tablet PO SEE
INSTRUCTIONS () for 6 days.
13. Azithromycin 600 mg Tablet Sig: Two (2) Tablet PO QFRIDAY
().
14. Leucovorin Calcium 25 mg Tablet Sig: One (1) Tablet PO
QFRIDAY ().
15. Pyrimethamine 25 mg Tablet Sig: Two (2) Tablet PO QFRIDAY
().
16. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID
(4 times a day) as needed for thrush.
17. Megestrol Acetate 40 mg Tablet Sig: Ten (10) Tablet PO QID
(4 times a day).
18. Truvada 200-300 mg Tablet Sig: One (1) Tablet PO once a day.



Discharge Disposition:
Home

Discharge Diagnosis:
Right oral cavity mass


Discharge Condition:
Good

Discharge Instructions:
Rinse mouth with saline before and after meals.
If your loose bowel movements persist or you have associated
abdominal pain, call the ENT resident on-call.

Followup Instructions:
Follow-up with Dr. [**Last Name (STitle) 1837**] in 1 week.
Follow-up with your Infectious Diseases doctor [**First Name (Titles) 3**] [**Last Name (Titles) 1988**].



Completed by:[**2108-9-22**]
{'Herpetic gingivostomatitis,Human immunodeficiency virus [HIV] disease,Other postoperative infection,Cellulitis and abscess of face,Unspecified protein-calorie malnutrition,Chronic viral hepatitis B without mention of hepatic coma without mention of hepatitis delta,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation'}


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: Right oral mass

PRESENT ILLNESS: This is a 52- year old gentlman with history of HIV and AIDS
admitted with a rapidly growing oral mass on the right side
concerning for lymphoma vs. kaposi's vs. SCC.  The mass was
first noticed on prior hospitalization, while he was
aggressively being treated for refractory CD4 count.

MEDICAL HISTORY: AIDs (CD4 13, VL 363) diagnosed with HIV in [**2092**],
hemochromatosis, hemorroids, HBV

MEDICATION ON ADMISSION: 

ALLERGIES: Bactrim

PHYSICAL EXAM: alert and oriented x 3
RRR, no mrg
CTAB
S/NT/ND +bs
incision CDI wit stitches visible.  No erethema, minimal edema.
LE: no edema, +SCD's.

FAMILY HISTORY: h/o ETOH abuse with siblings and sons

SOCIAL HISTORY: Lives alone in an apartment on the [**Location (un) 448**] in [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 669**].
Has brother and 2 sons in the area who are supportive. Former
teamster who worked setting up expos. Divorced. 

### Response:
{'Herpetic gingivostomatitis,Human immunodeficiency virus [HIV] disease,Other postoperative infection,Cellulitis and abscess of face,Unspecified protein-calorie malnutrition,Chronic viral hepatitis B without mention of hepatic coma without mention of hepatitis delta,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation'}
